Natural esophageal defenses:
Strengths and limitations

When certain natural mechanisms fail to adequately protect the mucosa, the esophagus is more susceptible to potentially harmful, acid-activated pepsin.

How esophageal defenses help — and how they can fall short

Secondary peristalsis
Propels refluxed gastric contents back into the stomach
However, the defense afforded by this type of motility sometimes does not adequately clear the esophagus1
Lower esophageal sphincter (LES)
The primary defense against reflux of gastric contents
In cases of LES incompetence from factors such as intrinsic weakness, iatrogenic causes (eg, myotomy for achalasia), foods, or anatomic reasons (eg, hiatal hernia), this anatomic barrier is compromised1
Esophago-salivary reflex
Initiates flow of acid-neutralizing bicarbonate-rich saliva
Some disease states diminish salivary output, thereby reducing natural acid-neutralizing capability1
Epithelial barrier
Includes tight junctions in the squamous mucosa that resist acid penetration
When this barrier is disrupted, acidified proteases, such as pepsin, can break down the collagen component of the basement membrane. Neutralizing the acid on the esophageal surface can help reduce pepsin activity
Submucosal glands
Secrete acid-neutralizing bicarbonate
The amount of acid reflux can overwhelm the neutralizing capacity of this innate protective mechanism1

Acid + Pepsin = Painful Esophageal Symptoms

Experimental studies suggest that at a pH of 1.3 or above, acid alone will not injure the esophagus. However, the harmful effects of pepsin on the esophageal mucosa are maximal at pH 1-3.3. Raising the pH in the esophagus can decrease the activity of pepsin.1

Supplement your treatment program with Mylanta for symptom relief

  • Immediately neutralizes the residual acid from gastric refluxate
  • Provides symptomatic relief of hyperacidity associated with peptic esophagitis, peptic ulcer, gastritis, gastric hyperacidity, and hiatal hernia
  • Delivers powerful acid-fighting ingredients and contains simethicone to relieve symptoms of excess gas

Recommend liquid Mylanta for its strong acid-neutralizing power

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References

  1. 1. Hirschowitz BI. Pepsin and the esophagus. Yale J Bio Med. 1999;72:133-143.