Sucralfate (Carafate)

In the drug blog business, it can get awfully tempting to just paraphrase Wikipedia articles all the time. I've done it on occasion, I will shamefully admit, but I usually try and get actual research articles as sources for my posts. And when I do succumb to my more basic urges (greed and laziness, if you must know) and 'rip off' the Wik, I just pick out a few choice tidbits, change 'em 'round and explain things differently so it isn't plagiarism, and then add some amusing little comments. It's not like I'm cutting and pasting. Anyway, I just had a lecture on gastrointestinal drugs, being a pharmacology student and all, and I thought this one in particular was pretty neat.
Sucralfate is a sucrose sulfate-aluminum complex (a sugar with a bunch of metal salts attached to it) that is used to treat peptic ulcers, particularly those that arise in the duodenum, as well as gastroesophageal reflux disease (GERD).
Peptic ulcers are essentially holes burned through the lining of the gastrointestinal (GI) tract (specifically, the stomach or small intestine) by stomach acid, which is mostly hydrochloric acid that is secreted by specialized stomach cells called parietal cells. Normally the stomach is lined with mucus, which prevents the acid from eating up the stomach (ha, it's the stomach, get it?). However, in the event of things like chronic gastritis due to infection with Helicobacter pylori, psychological stress, chronic use of non-selective NSAIDs, smoking, and/or Zollinger-Ellison syndrome, either the mucus barrier is compromised or else the amount of acid being produced is abnormally increased, resulting in ulceration. The duodenum is the first section of the small intestine (there are three sections in total) that the stomach empties into. Incredibly, it is this part of the GI tract, not the stomach, that is the main site of peptic ulcer development.
When taken orally (by mouth), sucralfate travels to your tummy and does two things. Firstly, it binds up and neutralizes stomach acid, bile acids, and digestive enzymes. Secondly, it binds to proteins on the surface of ulcers to form complexes that cover and protect them from further exposure to stomach acid, bile acids, and digestive enzymes, thus preventing them from developing further and helping them to heal.


4 chemically inspired comments:

Toaster Sunshine said...

It should also be mentioned that chronic gastritis can lead to an increased likelihood of developing cancers of the tissues affected. Gastritis involves long-term inflammation of the affected tissues, which means that these tissues, and their DNA, are under increased oxidative stress. And as such, the probability that a key proliferation regulatory gene will be oxidatively mutated is also increased, thus leading to a greater risk of cancer.
Disclosure: The lab I work in is modelling the inflammation response in SCID mice to H. pylori and enterohemorraghic E. Coli.

CDC said...

It should also be also mentioned that too much pizza necessitates Tums.

CND said...

Hey toaster. Nice comment. Now you got me wondering what other chronic inflammatory diseases increase the risk of cancer.

Ah, Chris. This blog is a better place thanks to you. In my case, too much pizza necessitates exploding.

ButterPetals said...

I dont think the question was ever answered about whether my use of Carafate caused my vaginal yeast.
Also, is my use of prevacid helpful for minimizing my stomach acid? Or does prevacid set the stomach up for precancerous cell changes. If I change my diet, does that help?