In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.

However, this neutralization reaction between antacids and gastric acid produces carbon dioxide (CO₂). Accumulation of CO₂ can lead to stomach distention and belching, causing discomfort. Furthermore, excessive doses of antacids can result in the absorption of unreacted alkali. This absorption raises the alkalinity of the blood, leading to a condition known as metabolic alkalosis.

Magaldrate, a hydroxymagnesium aluminate complex, is employed to address these side effects. Magaldrate transforms into poorly absorbed magnesium and aluminum hydroxides in the stomach's acidic environment. This transformation imparts a sustained antacid effect, mitigating the discomfort caused by excessive CO₂ production.

It's important to note that the efficiency of antacids hinges on several factors, including their dissolution rate, water solubility, reaction speed with gastric acid, and gastric emptying rate. Interestingly, the clearance of antacids is faster on an empty stomach. However, when taken with food, their duration of action is prolonged, providing a longer-lasting relief from gastric discomfort.

Antacids are pivotal in the delicate balance between neutralizing gastric acidity and avoiding unwanted side effects.