Reflux medications are often taken to control
acid reflux, a very common medical problem. Two of the most common reflux control medications
include H2 Blockers like pepcid as well as Proton Pump Inhibitors like prilosec. To understand how these medications work,
let’s take a closer look at the stomach lining. The two main cells responsible for stomach
acid secretion are the ECL and parietal cells. A nerve signal releases a neurotransmitter
called acetylcholine, depicted by white spheres, which attach to the purple muscarinic receptors
found on both these cell types. The ECL cell releases a different neurotransmitter
called histamine, depicted by blue spheres, which then attach to the orange H2 receptors
found on the parietal cell. When both receptor types are activated, the
parietal cell sends a very strong signal to the proton pumps to secrete acid into the
stomach cavity. When a H2 Blocker reflux medication is taken,
it blocks the H2 receptors on the parietal cell preventing the histamine from attaching. Only the muscarinic receptor activated by
acetylcholine triggers a weak signal for the proton pumps to secrete some acid. A proton pump inhibitor medication works further
downstream in the activation pathway. It shuts down the proton pumps from secreting
any acid no matter how strongly the parietal cell is activated. As such, proton pump inhibitor medications
are generally considered stronger than H2 blockers in preventing acid reflux. However, both types of reflux medications
are not recommended for long-term use since these medications can cause unacceptable side
effects. An alternative and safer reflux treatment
for long-term reflux control is sodium alginate derived from seaweed. When taken after meals, it coats the esophagus
and stomach lining, but more importantly, it creates a floating gelatinous raft on top
of the stomach secretions. This raft physically prevents reflux from
happening by plugging the opening into the esophagus whenever a reflux event is about
to occur. Of course, because it is derived from seaweed,
the stomach will eventually digest the alginate away which is why it must be taken after every
meal and at bedtime. This patient education video was sponsored
by RefluxRaft.