The role of saliva in acid reflux relief

What about chewing gums for acid reflux relief?

The importance of saliva in acid reflux relief can be predicted by considering a scenario where an individual is about to vomit. Vomit contains gastric substances which are extremely acidic and injurious. A protective reflex occurs before the individual prepares to vomit. Signals are sent from the brain to the salivary glands via the involuntary nervous system to cause increased saliva secretion, even before vomiting occurs. Thus, when vomiting does occur, there is already saliva available for acting to minimize the acidity and thus prevent tissue destruction.
Saliva is formed mainly in the major glands of the parotid, submandibular, and sublingual, as well as minor glands. The constituents of saliva are mediators of its various functions and effects in relation to acid reflux relief. As saliva is a viscous liquid mainly composed of water and containing mucin; one of its important functions is acting as a lubricant for the passage of food into the esophagus, moistening food and helping to create a food bolus, so it can be swallowed easily. Diminished salivary production deprives the swallowed food bolus of its water content and the lubricant effect of mucin, it would thus be irritating to the esophageal lining.
Saliva contains all the ions usually present in body fluids, and of these, bicarbonate ions which play a major role in determining the pH and buffering capacity of saliva. The primary salivary buffer is composed of bicarbonate (HCO3-). Bicarbonate is excreted through the duct system by means of an active transport mechanism. Salivary bicarbonate can help protect the esophgus against attack from refluxed acid produced by the stomach. This buffer system forms the first line of defense against acidic challenges, a salivary function of utmost importance in esophageal clearance and acid reflux relief.
Salivary responses to chewing and taste stimuli are innate. Salivary flow increases during eating. The physical action of chewing stimulates nerve endings in the tissues around the teeth. Flavorful substances stimulate taste buds. Both of these stimuli are potent initiators of salivary flow. Signals from nerve endings in the mouth evoke salivation by exciting the salivary centers in the brain stem. Salivary secretion is controlled by the autonomic nervous system. The importance of chewing and avoiding medications that affect the involuntary nervous system is thus quite clear for acid reflux relief. Smoking is also a known factor in the causation of dry mouth and should be stopped.
Secretion of the salivary glands is 1-1.5 liters daily. When salivary flow is too low, dry mouth (xerostomia) may result. Here, normal oral functions such as chewing and swallowing can be uncomfortable and difficult to perform and acid reflux is aggravated.
Emotional disturbances affect the rate of salivary secretion leading to xerostomia. A lowered rate of flow has been noted in patients suffering from depression. However, most xerostomia is due to medications used in the management of these problems. Again, these factors should be considered for proper management of acid reflux.

The role of Antacids in acid reflux relief

What about Tums for acid reflux relief?
Acid produced in the stomach is the main injurious factor inducing inflammation of the esophagus in acid reflux disease. Since Antacids are medicines that neutralize stomach acid, the refluxed contents would thus be free of the heartburn initiating component. Antacids have a rapid onset and short duration of action, and are most appropriate for rapid acid reflux relief for a short period of time. In contrast to H-2 receptor blockers and proton pump inhibitors which reduce acid production by the stomach, Antacids have no direct effect upon acid producing mechanisms. There are two types of Antacids: the first is sodium bicarbonate which chemically neutralizes the acid and is absorbable, accordingly its use is limited because of the associated systemic side effects. The second type is non-absorbable and acts by attracting acid molecules to its surface, consequently preventing their action, a process called adsorption. Calcium and magnesium salts are examples of the second group and are commonly used.
Acid rebound is a phenomenon encountered during the usage of antacids in which acid returns in greater concentration after the drug effect has stopped.
Another disadvantage of Antacids is that they interact with certain drugs and limit their simultaneous usage. They may also be associted with diarrhea and constipation.
Additional components of some formulations include dimethicone which reduces pain resulting from gaseous distention and alginic acid which, in combination with antacids, may help manage acid reflux.
Additional uses of non-absorbable Antacids include prevention of osteoporosis as the calcium salts would act as dietary supplement. Aluminum carbonate is also useful for binding phosphate, preventing the formation of urinary phosphate stones.
Antacids should be taken when gastric acidity is most likely to be increasing — namely, between one and three hours after each meal and at bedtime.
Examples of Antacids include:
* Aluminum hydroxide (Amphojel®, AlternaGEL®)
* Magnesium hydroxide (Phillips’® Milk of Magnesia)
* Aluminum hydroxide and magnesium hydroxide (Maalox®, Mylanta®)
* Aluminum carbonate gel (Basaljel®)
* Calcium carbonate (Alcalak®, Calcium Rich Rolaids®, Quick-Eze®, Rennie®, Titralac®, Tums®)
* Sodium bicarbonate (Bicarbonate of soda, Alka-Seltzer®)
* Hydrotalcite (Mg6Al2(CO3)(OH)16 · 4(H2O); Talcid®)
* Bismuth subsalicylate (Pepto-Bismol)
* Magaldrate + Simethicone (Pepsil)
Reduced stomach acidity may result in an impaired ability to digest and absorb certain nutrients, such as iron and the B vitamins. Since the normal acidity of the stomach normally kills ingested bacteria, Antacids increase the vulnerability to infection.

Related Posts:
The role of H2 receptor blockers in acid reflux relief
The role of Proton Pump Inhibitors in acid reflux relief