WHY DO APPARENTLY HEALTHY PEOPLE USE ANTACID TABLETS

Abstract

Proprietary antacids represent a multimillion dollar business in this country. Marketing surveys have shown that .apprx. 1/2 of American adults have used antacids. Of adults, 27% take 2 or more doses/mo. Of total antacid consumption, 75% is by heavy users, defined as > 6 doses/wk (< 5% of adults). An investigation was made on why apparently healthy people are heavy antacid users. Thirty-seven heavy users were evaluated. The median duration of antacid use was 20 yr, and most took antacids 2-6 times/day, concentrated through the work week. The primary diagnosis was reflux esophagitis in 31 (84%), peptic ulcer disease in 1 and nonulcer dyspepsia in 5. Some 95% had symptoms consistent with reflux esophagitis. Thirty-three completed a 1 mo. double-blind, randomized crossover trial of antacid tablets (14 meq neutralizing capacity/tablet) vs. placebo. Twenty-nine correctly identified the antacid product (P < 0.0001). Twenty-three subjects underwent Bernstein tests and endoscopy; 21 had positive Bernstein tests, 13 had definite esophagitis as determined endoscopically. Heavy proprietary antacid tablet use in the adult male apparently is not an expression of functional disease, but is due to reflux esophagitis, tablet use usually can be effective symptomatic treatment, and history apparently is an adequate evaluation for most heavy antacid tablet users.