Gastric secretions are essential for digestion. Hydrochloric acid in the stomach is produced by its glands. Like any acid, it is aggressive and harmful in increased amounts, but at normal levels it does not show a negative effect on the stomach. Any changes in the acid-base balance lead to malfunctions in digestion and diseases in the body.
Hydrochloric acid and gastric juice: what is it?
Gastric juice is a colorless acidic liquid containing mucus, enzymes, salts, and water. One of the most important in this cocktail is HCl. About 2.5 liters are released per day. Content of hydrochloric acid in the human stomach 160 mmol / l. If not for the protective mucous layer, it could violate the integrity of the organ. Its presence in the gastric secretion is necessary for normal digestion.
Where and how is it produced?
Hydrochloric acid plays a major role in the complex digestive system. The environment in the human stomach is provided by HCl. It is produced by parietal cells of the bottom and body of the organ. This is where it forms the most. In the course to the pH level decreases due to partial neutralization with bicarbonates. The mechanism of formation begins from the moment when a person catches the smell of food. The parasympathetic NS (nervous system) is activated, acetylcholine and gastrin irritate the receptors of parietal cells, which leads to the start of the production of hydrochloric acid. Its secretion occurs while there is food in the stomach. After its evacuation to the intestine, the synthesis is blocked by somatostatin.
Main functions
The role of gastric juice is determined by its components. The main functions of hydrochloric acid in the stomach are to denature proteins and protect the organ from bacteria. Complete digestion and assimilation of protein food is impaired if it has not been broken down under the influence of acid. Instead of useful amino acids, ammonia, gases and decay products are formed. Therefore, the cleavage of large peptide molecules with hydrochloric acid is essential for their complete assimilation. The enzyme pepsin, which is found in gastric juice, also breaks down proteins, but normal stomach acidity is required for its activity.
Pathogenic microorganisms enter the mouth with food. Here, under the influence of lysozyme, they are partially neutralized. Some of them enter the stomach, where they are killed by the secreted hydrochloric acid. The food contained here is evacuated to the intestines only after cleansing from bacteria. Otherwise, vomiting occurs, which is a kind of protective reaction.
In addition, the role of hydrochloric acid in gastric juice is to stimulate the production of secretin in the duodenum. It also plays a role in improving iron absorption, regulating the acid-base balance in the body, enhancing the secretory activity of the gastric glands and the pancreatic and motor activity of the stomach.
Causes of increased and decreased secretion
The aggressive contents of the stomach irritate the mucous membranes. - Wrong diet. Excessive consumption of fatty, spicy, smoked foods leads to increased production, and frequent overeating leads to a decrease in acid production.
- Poor chewing of food. Eating on the go and in a hurry leads to the fact that poorly chopped pieces of food enter the stomach. For their digestion and splitting, much more HCl is required, as a result of which its production increases.
- Stress. In a period of nervous tension, people go to extremes. Some eat continuously, others, on the contrary, forget about eating, someone starts drinking alcohol, etc. All this affects secretion.
- Medical treatment. Non-steroidal anti-inflammatory and hormonal agents can lead to increased acidity.
- Smoking. Toxic tobacco smoke disrupts the structural and functional activity of gastric cells.
- Helicobacter pylori. It releases substances that destroy the structure of the mucosa and the acid balance in the human stomach.
How does acidity disorder manifest itself?
Belching is accompanied by an unpleasant sour taste. If the acid-base balance is disturbed, a person feels discomfort. A key sign of elevated pH is severe pain in the pit of the stomach, which appears 2 hours after eating. In addition, patients in this group complain of sour belching, heartburn, intestinal colic, stool disorders, nausea and vomiting. If the acid in the human stomach is not enough, then the pain in the stomach will also be, but less pronounced and aching. The lack of HCl in the composition of gastric juice causes flatulence, frequent fungal and viral diseases, makes the human immune system weakened. In order to prescribe adequate treatment and prevent dangerous complications, such as ulcers and stomach cancer, it is necessary to diagnose secretion disorders in time.
Diagnosis of the level of hydrochloric acid
- Fractional sounding. With the help of special probes, gastric juice is aspirated and analyzed.
- Intragastric pH-metry. Sensors are inserted into the stomach cavity and measure the pH level directly in it.
- Acidotests. This method is based on a change in the color of urine after the patient has taken certain medications with a dye. The intensity of its staining is compared with a special scale and a conclusion is made about the lack or excess of acid in the stomach.
- At home, you can determine the level of acidity of gastric juice by drinking a glass of sour on an empty stomach. apple juice. The appearance after this of pain or burning in the stomach, a metallic taste in the mouth, will indicate its increase, and the desire to eat or drink something else sour - to decrease.
Hydrochloric acid is an integral part of gastric juice. This substance is involved not only in the digestive process, but also destroys harmful microorganisms that have entered the stomach. Despite the beneficial functions of acid, its excess is as dangerous as its deficiency. Deviation in one direction or another is accompanied by certain symptoms, which, together with the examination, will help to correctly determine the acidity of the stomach.
Normal stomach acidity
The pH balance of the most important organ of the gastrointestinal tract (gastrointestinal tract) is considered the main indicator of the health of the gastrointestinal tract. The most significant is the dynamic change in the acid-base balance during the day (in the antrum and other gastric regions).
There is a certain rate of stomach acidity, which varies significantly depending on the part of the digestive organ. There are also differences in the pH of the mucous membrane and the surface of the stomach. For example, a normal value in the lumen of the gastric body is a mark of 1.5–2.0 pH (the study is carried out strictly on an empty stomach). The acidity in the antrum of the stomach ranges from 1.3 to 7.4 pH units. In the deep epithelial layer, the indicator is in the region of 7.0 pH.
A medium is considered acidic if the pH is less than 7. If the pH is greater than 7, the medium is called alkaline. When it comes to zero acidity of the stomach, it means a neutral pH value of 7.
Important: the representatives of the stronger sex are most susceptible to gastrointestinal diseases associated with increased production of hydrochloric acid. This feature is due to the fact that the stomach of a man has 1.5 times more cells that produce this substance.
Low hydrochloric acid
The following symptoms correspond to a low level of acid in:
- excessive accumulation of intestinal gases;
- pain in the stomach and small intestine;
- frequent belching with a putrid odor;
- constant rumbling in the stomach;
- "empty" belching;
- stool disorder (regular constipation is replaced by diarrhea);
- feeling of heaviness in the stomach after eating.
A person with low hydrochloric acid production often has a desire to eat sour foods, such as sauerkraut. Black rye bread, citrus juices, pickles, and sour apples also cause great appetite.
Which is accompanied by zero acidity is a dangerous pathology that may not show any symptoms for a long period. The absence of a normal level of one of the components of gastric juice leads to the fact that harmful bacteria that have got along with saliva begin to multiply freely. For example, Helicobacter pylori, which can be contracted through common utensils, is a provocateur inflammatory process lining of the digestive tract.
The lack of acid in the gastric juice can be manifested by an increased appetite for various seasonings and spices.
Food that has entered the antrum of the stomach is poorly digested due to insufficient production of hydrochloric acid. Gradually, the patient develops iron deficiency anemia, osteoporosis and dementia. Untreated pathologies become chronic, and a person's well-being continues to deteriorate, because. gastric juice cannot cope with the breakdown of microelements in food into simpler compounds. In this case, not only drugs that normalize the acid-base balance are required, but also vitamin supplements for food.
Important: gastric anacidity is a phenomenon that may precede a malignant process in the stomach, so a visit to a gastroenterologist in case of symptoms of acid deficiency is mandatory.
High levels of acid in the digestive organ
An increase in stomach acid is manifested by the following symptoms:
- heartburn;
- sour taste in the mouth after eating;
- pain in the epigastric region;
- discoloration of the mucous membrane of the tongue and the appearance of a light coating on its surface;
- hungry pains;
- violation of the stool (mainly constipation);
- nausea or vomiting after eating.
People suffering from excessive acid production note that side effects taking non-steroidal anti-inflammatory drugs become nausea and stomach pain.
High acidity, left unattended for a long period of time, often turns into a peptic ulcer of the stomach or duodenum, the manifestations of which cause even more discomfort and complications.
Restoring normal pH levels
In order to restore the balance of acidity, it is necessary to take medicines of various groups:
- Antacid. These medicines are able to neutralize hydrochloric acid at the chemical level. For example, one of these funds is Almagel;
- Antibacterial. Such drugs are indispensable if you want to get rid of pathogenic microorganisms that inhabit the digestive organ (the most famous is Helicobacter pylori). Most often, antibiotics are chosen for this purpose. a wide range actions, however, before the results of the diagnosis, the appointment of potent drugs is not recommended;
- Immunomodulatory. Medicines that stimulate the immune system are prescribed to patients whose body is weakened against the background of a chronic gastrointestinal disease.
People suffering are shown drugs that have an inhibitory effect on the secretion of hydrochloric acid in the stomach. The most famous medicine of this action is considered "Omez".
Berries containing a large amount of ascorbic acid are considered a useful addition to the diet for chronic diseases of the gastrointestinal tract.
Hydrochloric acid secretion stimulants can increase the level of low acidity. A good therapeutic effect is also achieved through replacement therapy. For this, the doctor selects drugs that contain abomines, pepsins and hydrochloric acid components. To get rid of pain in the epigastric region, antispasmodic drugs are prescribed.
A change in the acid-base balance can occur against the background of nutritional errors, but most often the causes lie in diseases of the gastrointestinal tract. That is why it is recommended not to smooth out pathological symptoms, but to visit a doctor in order to begin to competently treat the root of the problem.
Diet for people with gastrointestinal problems
The menu of a person suffering from high acidity should be very sparing. The ideal dish in this case is an enveloping soup prepared on the basis of poultry broth or lean meat. It is better to grind the cereal added to the soup, making the hot dish mushy.
It is useful for a sick person to eat well-boiled (semi-liquid) oatmeal, rice or buckwheat porridge. On the table there should be bread with the addition of whole grains. Also, in a hyperacid state, fresh vegetables and fruits, legumes and dairy products are useful.
Restoring the acid-base balance has a beneficial effect on the intake of therapeutic mineral waters. 20 minutes before a meal, a glass of warm healing liquid should be drunk by people suffering from a lack of acid. Recommended water: Essentuki No. 17, No. 4, Arzni and Uglich. Before use, it is advisable to warm the water a little. If hydrochloric acid is released in excess, you can drink a glass of Borjomi, Dzhemruk or Kashinskaya mineral water an hour and a half before meals (it should also be warm).
In the diet of a person with a lack of hydrochloric acid, there should not be fresh products of plant origin. It is recommended to bake fruits and vegetables, and it is better to refuse legumes during the treatment period altogether.
On the table of a person who is faced with a pathology of the gastrointestinal tract, there should be steamed food. You can also eat boiled or baked foods. In the cooking process, it is unacceptable to use a large amount of salt, spices and hot spices. Also, rich broths and high-carbohydrate foods should be excluded from the menu. Drinks containing alcohol and caffeine are banned. Sausages, fast food and other food containing preservatives should also be discarded.
During an exacerbation of hyperacid gastritis, it is not recommended to eat hard-boiled eggs, because they are heavy enough to digest
If you suspect a chronic inflammatory process of the gastric mucosa, it is recommended to eat in small portions up to 6 times a day. In order to avoid the reflux of gastric secretions into the esophagus, after eating, it is better to take a walk or sit, avoiding resting in a horizontal position.
Home Ways to Regulate Acidity
You can use folk remedies to regulate the ph of the stomach if the cause of discomfort in the stomach lies in a violation of the diet or an unhealthy lifestyle. For example, to temporarily extinguish a sour taste in the mouth, ordinary baking soda. Its small amount is dissolved in a glass of water and drunk when a burning sensation appears in the esophagus. Dairy products are also able to neutralize part of the hydrochloric acid that has entered the esophagus. If you feel a sour aftertaste after eating, you can drink half a glass of milk in small sips.
People suffering from hyperacid inflammation of the gastric mucosa, it is useful to eat ripe figs. Freshly squeezed potato juice also has an acid-reducing effect. Patients with chronic gastritis drink ¾ cup of medicinal juice 3 times a day (1st time in the morning on an empty stomach, 2nd time - 1 hour before lunch and last time- before bedtime). Having taken a folk remedy, it is necessary to lie down for half an hour. The duration of the therapeutic course is 10 days.
To restore the normal state of the gastric mucosa with anacid gastritis, herbal decoctions, for example, from wild rose, pharmacy chamomile or cudweed, help. This medicine is drunk on an empty stomach, after consulting with the doctor. Another useful product for low acidity is honey. A little treat, taken before meals, well stimulates the production of gastric juice.
Recipes traditional medicine, which are designed to normalize acidity, cannot be tested on yourself without making sure that there are no chronic diseases of the biliary tract and other organs.
How to find out your pH level
It is impossible to know what caused fluctuations in the acid-base balance of the gastrointestinal tract without the use of modern diagnostic methods. The most accurate among them are:
- Daily intragastric pH-metry. The study is carried out by acidogastrometers - devices on which pH sensors are fixed. The procedure is considered the most informative, because it allows you to find out the level of acidity in several parts of the digestive organ at once;
- Esophageal impedance. The procedure is prescribed for people who are tormented by the taste of sourness or bitterness in the mouth. Allows you to track episodes of reflux of gastric contents into the esophagus;
- Manometry (high resolution) of the esophagus. It is necessary to find out the cause of reflux. With this method, you can find out about diaphragmatic hernia or frequent relaxation of the orbicular esophageal muscle.
- After carrying out all the necessary tests and based on the results of the examination, the attending physician will decide which medications the patient should take in a particular case.
Excessive or insufficient amount of hydrochloric acid in the stomach adversely affects not only the digestive tract, but also the body as a whole. Noticing that the acidity of the gastric juice is changing, the manifestations of the disease should not be eliminated before consulting a doctor.
The development of many diseases of the gastrointestinal tract can be associated with destabilization of the level of gastric acid, so you need to constantly maintain normal acidity, as well as know which acid in the human stomach is normal. With the development of unpleasant symptoms that indicate various pathologies, you should immediately seek help from a doctor. Read more about the acidity of the stomach and will be discussed in this article.
Gastric juice is a special liquid, which is characterized by a complex composition. Juice is produced by the stomach, or rather, by the cells of its mucosa. Outwardly, it looks a bit like ordinary glue: it is transparent and has no characteristic odor. In addition, gastric juice may contain small lumps of mucus. It consists of organic compounds, minerals, various enzymes, mucus, and gastrin, a hormone that is synthesized by the G-cells of the stomach.
On a note! Also, gastric juice contains hydrochloric acid, or, as doctors also call it, hydrochloric acid (a colorless, caustic liquid with a pungent odor). She plays an important role in the work digestive system, as it is found in gastric juice in large quantities.
Hydrochloric acid rate
It is worth noting that acidity of gastric juice is measured in units of pH. Under normal circumstances and in the absence of health problems, the acidity rate of human gastric juice should range from 1.5 to 2 pH. Diagnosis should be carried out on an empty stomach, otherwise the results of laboratory tests may be unreliable.
If we talk about the minimum and maximum allowable norm, these are, respectively, 0.86 and 8.3 pH. These indicators, as a rule, depend on the production of hydrochloric acid by the patient's stomach. According to statistics, the proportion of hydrochloric acid in the gastric juice of an absolutely healthy person ranges from 0.4% to 0.5%.
Factors that provoke a change in acidity
Consider the main reasons that contribute to the increase in acidity:
- improper or unbalanced diet;
- excessive consumption of smoked, fried or spicy foods;
- Availability bad habits negatively affecting the state of the gastrointestinal tract (smoking and alcohol abuse);
- consequences of taking strong medications. First of all, this applies to analgesics, antibacterial and anti-inflammatory drugs that irritate the gastric mucosa.
Malnutrition is one of possible causes increase in acidity
Since only metabolic processes can reduce the level of hydrochloric acid in the stomach, this most often happens with older people, whose metabolic processes in the body slow down with age. The most common causes of low stomach acid include the following factors:
- the development of an inflammatory process that affects the organs of the gastrointestinal tract;
- poor digestibility of food consumed;
- atrophy of the gastric mucosa;
- hormonal imbalance;
- poor metabolism (metabolism).
Most of these factors are influenced by the patient's lifestyle, in particular, his diet. Therefore, to maintain the digestive system and the whole body in a healthy state, doctors recommend reconsidering your diet.
Characteristic symptoms
The following symptoms may indicate a decrease or increase in hydrochloric acid in the patient's stomach:
- spasmodic contractions of the walls of the stomach, usually manifested in between meals;
- pain in the right side of the abdomen;
- burning in the stomach;
- sour belching that occurs after eating;
- the formation of white or green plaque on the surface of the tongue;
- the appearance of intestinal colic, which is associated with a violation of the digestive processes;
- stool disorder (diarrhea or constipation);
- increased gas formation;
- fading of the hairline, which is often accompanied by hair loss;
- drying of the patient's skin;
- the appearance of symptoms of anemia;
- Acne may appear on the skin of the patient's face.
In the process of increasing or decreasing the level of acidity, the patient's gastric secretion does not function properly, sometimes intermittently, due to which hydrochloric acid is produced in excess or deficiency. These disorders often provoke the development of additional symptoms:
- decreased immunity - both local and general;
- the appearance of signs of toxicosis;
- flatulence, bloating;
- disruption of the gastrointestinal tract;
- irritation of the mucous membrane of the larynx and pharynx, which occurs due to the cough reflex;
- sphincter irritation;
- the development of an inflammatory process that affects the respiratory system of the patient;
- violation of the intestinal microflora.
On a note! Violation of the acid balance in the stomach negatively affects metabolic processes, as a result of which the breakdown of proteins in the body occurs slowly. The patient's intestines absorb poorly or do not absorb useful substances (minerals and vitamins) at all, which leads to a sharp decrease in the patient's weight. In rare cases, anemia develops.
Methods of treatment
After conducting a diagnostic examination, the doctor will be able to make an accurate diagnosis and prescribe the appropriate treatment. The main task of therapy is to normalize the level of hydrochloric acid in gastric juice. For this, various methods of treatment are used, including taking medications, a therapeutic diet and the use of traditional medicine.
Pharmacy preparations
To normalize the acidity of the stomach, the patient is prescribed drugs different groups. What kind of drug is suitable in your particular case - only the doctor knows, so you can not self-medicate.
Table. Review of drugs for the normalization of acid in the stomach.
| Name of the drug, photo | Description |
|---|---|
| A common drug used as a depressant drug that stabilizes the secretion of gastric juice. It has several contraindications, so be sure to read the instructions before using it. |
| An antiulcer drug that belongs to the group of histamine blockers. It is often prescribed in the treatment of various gastroenterological diseases, among which is the increased acidity of the stomach. Produced in the form of tablets. |
| The action of this drug is to block cholinergic receptors, as well as to form a protective barrier on the walls of the stomach, which protects them from the negative effects of hydrochloric acid. The tool belongs to the group of antacids. |
| The action of soda is to neutralize hydrochloric acid in the stomach of the patient, so it is often used for increased acidity of the stomach. But here you need to be extremely careful, as an overdose can harm your health. Therefore, all actions must be coordinated with the attending physician. |
| Another drug whose action is based on the stabilization of the production of hydrochloric acid. The active ingredient is aluminum hydroxide. |
To avoid serious consequences, it is necessary to coordinate all your actions with your doctor. Otherwise, you risk not only not coping with the pathology that has arisen, but also provoking other health problems.
Folk remedies
As an addition to traditional therapy, traditional medicine is often used. There is still no official confirmation of the effectiveness of the use of traditional medicine for increased or decreased acidity of the stomach, but this does not stop traditional healers.
The most common folk remedies- This:
- freshly squeezed aloe vera juice;
- chamomile tea;
- decoction of ginger, which improves the digestive processes in the body;
- liquorice root;
- mastic (you can easily find it in health food stores).
But despite the naturalness of traditional medicine, improper use of them can lead to undesirable consequences. To avoid trouble, you need to consult a doctor. First of all, this is necessary to exclude an allergic reaction to individual components of medicines.
Nutrition
Following a special diet is another important part of the treatment. As a rule, it is aimed at normalizing the work of the gastrointestinal tract. First of all, the patient should exclude from his diet:
- strong tea and coffee;
- berries, citrus;
- sweets;
- carbonated drinks;
- fatty, fried, sour and spicy foods;
- savory soups.
At the same time, the following foods should be added to the diet:
- boiled potatoes, cauliflower;
- steamed egg omelet;
- mineral still water;
- crumbly cereals (buckwheat, rice, oatmeal);
- vegetable puree;
- low-fat varieties of fish and meat;
- low-fat dairy products.
On a note! It is advisable to replace tea and other drinks with clean water, and doctors recommend eating in small portions, but often. This will avoid overeating, which negatively affects the stomach and other organs of the digestive tract, overloading them. Only subject to proper diet you can expect a quick recovery.
Prevention measures
There are many different methods to prevent an increase in stomach acid. After all, it is much easier to prevent a disease than to cure it, so doctors recommend following preventive measures. Below is a step-by-step instruction, the observance of which will avoid many problems with the stomach, including violations of the secretion of hydrochloric acid.
Step 1. Eat right. A healthy and balanced diet will help prevent the development of many gastroenterological diseases. Make sure your diet includes healthy foods such as beans, fish, low-fat dairy products, poultry, vegetables, and fruits. At the same time, sugar and salt in large quantities, fatty foods and other foods that increase blood cholesterol should be avoided.
Step 2 Get rid of excess weight, if necessary. Excess weight, as a rule, negatively affects not only the cardiovascular, but also the digestive system.
Step 3 Eat small. This means that you need to eat in small portions, but often (4-5 times a day). This will speed up the metabolic processes in the body. Also, experts recommend paying attention not only to what you eat, but also how you do it. All food must be thoroughly chewed before swallowing, otherwise the stomach will be subjected to increased stress.
Step 4 Get regular exercise. This will not only speed up metabolic processes, thereby improving the functioning of the digestive system, but also lose a couple of extra pounds. To do this, it is enough to engage in any kind of sport 3-4 times a week. Great for swimming or cycling. Try to find for yourself what you like.
Step 5 Give up smoking and other bad habits that negatively affect the body. We are also talking about alcohol abuse, night snacks, overeating, etc. Following these recommendations will improve your health and, most importantly, prevent stomach problems. read our article.
Video - Increased acidity of the stomach
Located mainly in the fundus and body of the stomach. The concentration of hydrochloric acid secreted by the parietal cells is the same and equal to 160 mmol / l, but the acidity of the secreted gastric juice varies due to a change in the number of functioning parietal cells and neutralization of hydrochloric acid by the alkaline components of gastric juice.
The presence of other acids in the stomach in a healthy person is negligible. Sometimes there is lactic acid in the stomach, which is the result of the vital activity of lactic acid bacteria (lactobacilli, enterococci, lactococci lactis, etc.), which can exist only in the absence of hydrochloric acid. The presence of lactic acid in the stomach indicates a significantly reduced acidity of the stomach or the complete absence of secretion of hydrochloric acid. Most often, lactic acid is found in gastric contents in stomach cancer.
For a correct assessment of the state of the organs of the gastrointestinal tract, the value of acidity must be determined simultaneously in different parts of the stomach or in different parts of the esophagus, stomach and duodenum. For the correct diagnosis of diseases, it is important to have information about the graph of changes in acidity over time (pH-gram) and the dynamics of changes in acidity after taking certain stimulants or drugs.
Production and neutralization of acid in the stomach
One of the main functions of the gastrointestinal tract is secretory, ensuring the production and secretion of digestive juices by glandular cells containing enzymes and factors that contribute to their activation. For the normal course of the processes of gastric digestion, the rhythmic release of hydrochloric acid into the lumen of the stomach is necessary. The constant secretion of hydrochloric acid provides the conditions for the proteolytic action produced by the main (another name for zymogenic) cells of the gastric mucosa pepsin, denatures proteins, and provides a bactericidal effect.The gastric mucosa is divided into 2 main zones: a zone that produces hydrochloric acid, and a zone that releases bicarbonates designed to neutralize hydrochloric acid.
The acid-forming zone is located at the level of the anatomical body and the cardial part of the stomach. In this zone there are a large number of parietal cells (in men - from 960 to 1,260 million cells, in women - from 690 to 910 million) that produce hydrochloric acid.
The mucous membrane of the stomach contains a large number of endocrine cells that produce a number of hormones. 35% of the endocrine cells of the stomach of a healthy person are enterochromaffin-like (ECL-) cells that secrete histamine, 26% are G-cells that secrete gastrin. In third place in terms of numbers are D-cells that secrete somatostatin. Gastrin, histamine and acetylcholine stimulate the production of hydrochloric acid, while somatostatin and prostaglandins inhibit it.
Additional cells of the gastric mucosa secrete protective mucus with an alkaline reaction. Mucus keeps intact the entire array of gastric cells in contact with aggressive gastric contents. In case of violation of the production of protective mucus, its destruction or a relatively insufficient amount, the aggressive gastric environment adversely affects the gastric mucosa, causing inflammation - gastritis, or leading to ulcers in the stomach and duodenum.
Thus, the stomach is complex system containing both aggressive and defensive factors. Violation of their interaction leads to various pathological conditions, which can be called diseases of the stomach. The best method for elucidating the relationship between these factors is multichannel intragastric pH-metry (Stupin V.A.).
The value of the acidity of the stomach
The maximum observed acidity in the stomach is 0.86 pH, which corresponds to an acid production of 160 mmol/l. The minimum acidity in the stomach is 8.3 pH, which corresponds to the acidity of a saturated solution of HCO 3 - ions. Normal acidity in the lumen of the body of the stomach on an empty stomach is 1.5-2.0 pH. The acidity on the surface of the epithelial layer facing the lumen of the stomach is 1.5–2.0 pH. Acidity in the depth of the epithelial layer of the stomach is about 7.0 pH. Normal acidity in the antrum of the stomach is 1.3–7.4 pH.For reference: the pH value = 7 corresponds to the neutral value of acidity. At a pH below 7, the environment is acidic; at a pH above 7, it is alkaline.
Above is a graph of acidity (daily pH-gram) of the body of the stomach of a healthy person (dashed line) and a patient with a duodenal ulcer (solid line). The moments of eating are marked with arrows with the inscription "Food". The graph shows the acid-neutralizing effect of food, as well as the increased acidity of the stomach with a duodenal ulcer (Yakovenko A.V.).
In newborns, the acidity in the stomach before the first feeding ranges from 4.0 to 6.5 pH, which indicates the absence of free hydrochloric acid, which appears only at the first feeding. After the first feeding, the acidity value in the stomach of a newborn is in the range from 1.5 to 2.5 pH (Rimarchuk G.V. and others).
Acidity at various points in the stomach
The figure below shows the points of the gastroduodenal zone, in which the study of acidity is carried out during gastroduodenoscopic examination - endoscopic pH-metry. Since the introduction of the gastroscope is an acid-stimulating procedure, the pH values measured by endoscopic pH-metry are considered to be stimulated.
The spread of acidity fluctuations in patients with no structural changes in the gastric mucosa are presented in the table below (Sotnikov V.N. et al.):
| point number in the figure | Point localization | Limits of acidity fluctuations, units pH | Meanacidity, units pH |
| 1 | "Lake" | 0,9 – 2,2 | 1.47±0.1 |
| 2 | Fornix of the stomach | 0,9 – 4,6 | 1.96±0.38 |
| 3 | Body of stomach, posterior wall | 1,0 – 1,8 | 1.2±0.1 |
| 4 | Body of stomach, anterior wall | 0,9 – 1,4 | 1.1±0.1 |
| 5 | Antrum, lesser curvature | 1,6 – 7,2 | 4.6±0.4 |
| 6 | Antrum, greater curvature | 1,3 – 7,4 | 4.6±0.4 |
| 7 | Bulb duodenum, anterior wall |
5,6 – 7,9 | 6.5±0.25 |
Methods for determining the acidity of the stomach
1. The acidity of the stomach is determined by the degree of urine staining, for which ion-exchange resins such as "Acidotest", "Gastrotest" and others are used. The accuracy of the method is very low and, therefore, it has hardly been used recently.
2. Fractional sounding of the stomach. The contents of the stomach are aspirated with a rubber tube, and then the acidity of the gastric juice is measured in the laboratory. In the process of suction, the contents of the stomach, obtained from different areas of the stomach, are mixed. In addition, in the process of suction, the normal functioning of the stomach is disturbed, and the method gives distorted, approximate results.
3. The most informative and physiological method - measuring acidity directly in the gastrointestinal tract - intragastric pH-metry. Allows with the help of special devices - acid gastrometers, equipped with pH probes with one or more pH sensors, to measure acidity simultaneously in different areas of the gastrointestinal tract for a long time. Depending on the type of diagnostic task, there are: express pH-metry, short-term pH-metry, daily pH-metry and endoscopic pH-metry.
Estimation of acid formation and acid neutralization of the stomach according to the level of acidity
To assess the state of the process of acid formation in the stomach, short-term pH-metry is used. The table below shows the relevant criteria:Status assessment neutralizing function of the stomach carried out by calculating the difference between the values of the minimum acidity (which corresponds to the maximum pH value) in the antrum and the maximum acidity (corresponding to the minimum pH) in the body of the stomach:
Increased acidity of the stomach. Symptoms
The cause of many diseases of the digestive tract is an imbalance in the processes of acid production and acid neutralization. Prolonged hypersecretion of hydrochloric acid or insufficiency of acid neutralization, and, as a result, increased acidity in the stomach and / or duodenum, causes the so-called acid-dependent diseases. Currently, these include: peptic ulcer of the stomach and duodenum, gastroesophageal reflux disease (GERD), erosive and ulcerative lesions of the stomach and duodenum while taking aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), Zollinger-Ellison syndrome, gastritis and gastroduodenitis with high acidity and others.In general, it can be said that for the successful treatment of most acid-dependent diseases, it is important that the pH level in the stomach be more than 4.0 for at least 16 hours a day. More detailed studies have established that each of the acid-dependent diseases has its own critical level of acidity, which must be maintained for at least 16 hours a day (Isakov V.A.):
| Acid related diseases |
The level of acidity required for healing, pH, not less |
| Gastrointestinal bleeding | 6 |
| GERD complicated by extraesophageal manifestations | 6 |
| Quad or triple therapy with antibiotics | 5 |
| Erosive GERD | 4 |
| Damage to the gastric mucosa caused by the use of non-steroidal anti-inflammatory drugs | 4 |
| functional dyspepsia | 3 |
| Maintenance Therapy for GERD | 3 |
In the treatment of conditions with high acidity, antacids or antisecretory drugs are used. At the same time, antacids should not be considered as "primary therapy" drugs, only as symptomatic or "on demand" drugs. The most effective drugs that allow the longest time to neutralize the production of hydrochloric acid in the stomach are proton pump inhibitors. However, in some patients, in particular, for genetic reasons, specific drugs do not give the proper acid-blocking effect, and in order to achieve a therapeutic result, a special selection of antisecretory agents is required, performed using pH monitoring (Belmer S.V.). 
The main symptoms of hyperacidity, in fact, are symptoms of the acid-related diseases listed above. For diseases of the esophagus - this is heartburn, for gastric and duodenal ulcers, in particular, pains that are usually paroxysmal, less often - aching in nature, usually medium duration or long-term, with localization in the epigastric, pyloroduodenal regions or in the umbilical region, while after eating the pain usually disappears, and between doses it increases. With pyloric insufficiency, acid enters the duodenal bulb from the stomach, and, in the presence of mucosal disorders in the bulb, causes pain in the right hypochondrium. However, it is impossible to draw conclusions about the presence of increased acidity only on the basis of the patient's sensations; to establish the correct diagnosis, a mandatory instrumental study is necessary.
See also: "Diets for gastritis with high and low acidity".
Decreased acidity of the stomach. Symptoms
Decreased acidity is observed with anacid or hypoacid gastritis or gastroduodenitis, as well as with stomach cancer. Gastritis (gastroduodenitis) is called anacid or gastritis (gastroduodenitis) with low acidity, if the acidity in the body of the stomach is approximately 5 units or more. pH. The cause of low acidity is often the atrophy of parietal cells in the mucous membrane or a violation in their functions.
Even in the absence of any gastrointestinal symptoms, low acidity is serious problem. The acid in the stomach provides a bactericidal effect. With acid deficiency, the protection is noticeably weakened and microorganisms can freely enter the intestine along with food, violating its microflora. People suffering from anacid gastritis often have indigestion when its mucous membrane becomes inflamed. Against this background, various pathologies are more likely to develop due to the action of infections, including
