Monday, September 27, 2010

Sanofi Aventis, medical experts brainstorm on the management of peptic disorders

…as it launches antacid ‘Maalox’ into Nigeria
Alexander Chiejina

More often than not, some Nigerians develop one form of abdominal pain, bloating and abdominal fullness, nausea, copious vomiting, painful sensation at the chest while eating, copious vomiting etc. no name but a few. This discomfort experience by these individuals propels them to purchase pain relieving drugs like NSAIDs (non-steroid anti-inflammatory drugs) like aspirin, diclofenac, ibuprofen, ketoprofen etc. across the counter without the prescription of a physician.

To some, after consumption of this drug without eating, or side effects end up with sudden large bleeding which at the end may become life-threatening. For some, it may degenerate to the development of a stomach disorder which results in the erosion of the gastro-intestinal wall and the spillage of stomach or intestinal content into the abdominal cavity. Giving this avoidable realty, experts have called for the care in the use of antacids in the management of acid peptic disorders.

Speaking at the launch of Maalox, an antacid developed by Sanofi Aventis in Lagos recently, Funmilayo Lesi, consultant gastroenterologist, College of Medicine, University of Lagos, said that acid peptic disorder encompass a broad range of clinical disorders involving the oesophagus, stomach and duodenum with significant impact of the disease on morbidity and quality of life, economic activity and productivity. Lesi revealed that a major causative factor of gastric and duodenal ulcers in humans is chronic inflammation by bacterium Helicobacter pylori which colonizes the antral mucosa of the stomach.

The medical expert stated that the immune system is unable to clear the infection, despite the appearance of antibodies hence the bacterium cause a chronic active gastritis (type B gastritis), resulting in a defect in the regulation of gastrin production by that part of the stomach, and gastrin secretion which can either be decreased or increased.

In her words “Gastrin stimulates the production of gastric acid by parietal cells and, in H. pylori colonization responses that increase gastrin, the increase in acid can contribute to the erosion of the mucosa and therefore ulcer formation. However, the timing of the symptoms in relation to the meal may differentiate between gastric and duodenal ulcers.

A gastric ulcer would give epigastric pain during meal as gastric acid is secreted or after the meal as the alkaline duodenal contents reflux into the stomach. Symptoms of duodenal ulcers would manifest mostly before the meal when acid (production stimulated by hunger) is passed into the duodenum. However, this is not a reliable sign in clinical practice. Also, the symptoms of peptic ulcers may vary with the location of the ulcer and the patient's age.

Furthermore, typical ulcers tend to heal and recur and as a result the pain may occur for few days and weeks and then wane. Pain is usually caused by the ulcer but may be aggravated by the stomach acid when it comes into contact with the ulcerated area. The pain caused by peptic ulcers can be felt anywhere from the navel up to the breastbone; it may last from few minutes to several hours and may be worse when the stomach is empty. Also, sometimes the pain may flare at night and it can commonly be temporarily relived by taking anti-acid medication.] However, peptic ulcer disease symptoms may be different for every sufferer,” Lesi disclosed.

Lesi noted that another major cause of ulcer is the use of NSAIDs and stress which as a possible cause, or at least complication, leads in the development of ulcers.
Explaining the dynamics of antacids used to the treatment of ulcer, Chijioke Onyia, managing director, Pinecrest Healthcare limited revealed that antacid performs a neutralization reaction, i.e. they buffer gastric acid, raising the pH to reduce acidity in the stomach.

Onyia stated that when gastric hydrochloric acid in the stomach reaches the nerves in the gastrointestinal mucosa, they signal pain to the central nervous system. He noted that this happens when these nerves are exposed, as in peptic ulcers. The gastric acid may also reach ulcers in the esophagus or the duodenum.
In his words “antacids like Maalox show the most rapid onset of action and provide faster relief of symptoms. However they may cause an "acid rebound not suitable for all patients owing to its components like calcium carbonate and sodium bicarbonate which counteracts stomach acidity.”

No doubt, with stomach pain been the first to signal a peptic ulcer, it is important that people who develop this see their physician as they may treat ulcers without diagnosing them with specific tests and observe if the symptoms resolve, meaning their primary diagnosis was accurate.

For Frank Umeh, Medical Manager, North East Zone, Sanofi Aventis Pharmaceuticals, Maalox chewable tablets are used for relieving pressure, bloating, and gas in the digestive tract. Umeh hinted that It may also be used for other conditions as determined by your doctor.

“Maalox chewable tablet is an antiflatulent. It works by breaking up gas bubbles, which makes gas easier to eliminate. Contact your doctor or health care provider right away prior to the usage of the drug. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: if you are pregnant, planning to become pregnant, or are breast-feeding, if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement etc. This is because some medicine may interact with Maalox. However, no specific interactions with Maalox Anti-Gas Chewable Tablets are known at this time. More importantly, Check with your health care provider before you start, stop, or change the dose of any medicine,” Umeh concluded.

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