Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?
A. To inhibit mucus production.
B. To neutralize acid production.
C. To stimulate mucus production.
D. To stimulate hydrogen ion diffusion back into the mucosa.
Correct Answer: C. To stimulate mucus production.
The mucosal barrier fortifiers stimulate mucus production and prevent hydrogen ion diffusion back into the mucosa, resulting in accelerated ulcer healing. Sucralfate, a polymer of sucrose with aluminum hydroxide, forms a protective coating on the mucosal lining, particularly in ulcerated areas. In the presence of acid, it becomes a gel that adheres to epithelial cells and ulcer craters.
Option A: Misoprostol is a prostaglandin analog that increases the release of bicarbonate and mucin (a component of mucus) and reduces acid secretion by binding to prostaglandin receptors on parietal cells. Because NSAIDs (nonsteroidal anti-inflammatory drugs) inhibit prostaglandin formation, a synthetic prostaglandin such as misoprostol is sometimes given to reduce NSAID-induced damage.
Option B: Antacids neutralize acid production. The antacids reduce the acid reaching the duodenum by neutralizing the acid present in the stomach. The salts’ mechanism of neutralization of acid varies, and each salt has a different mechanism with the ultimate goal of acid neutralization.
Option D: The mucosal barrier is the name given to the barrier in the stomach that resists the back-diffusion of hydrogen ions. The barrier is a layer of thick mucus secreted together with an alkaline fluid. Since the mucus is a gel, it entraps the alkaline fluid so that the stomach is coated.
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