October 5, 2001 (Ira Pilgrim)


Advertising may be described as the science of arresting the human intelligence long enough to get money from it.

Stephen Butler Leacock

Millions of people take drugs to reduce stomach acid. Do they do any good?

The usual reason that people take a wide variety of drugs is heartburn. Heartburn has nothing to do with the heart. Heartburn happens when stomach juices, which are highly acidic, end up in the esophagus, the tube that goes from the mouth to the stomach. The stomach is lined with mucous producing cells which protect the stomach lining from being digested by the hydrochloric acid that is found in the stomach. The esophagus is lined with the same type of cells that line the mouth. If you put some hydrochloric acid in your mouth, you would find out in a hurry how much it burned.

I rarely eat heavily spiced Mexican food for dinner. It is too spicy for even my iron-lined stomach. I end up with heartburn. Heartburn is very easy to fix. I take a little bit of water and add a pinch of baking soda(sodium bicarbonate) and sip just a little bit of it. This neutralizes the acid in the esophagus and stops the heartburn. I don't take enough of the soda to affect the acid in my stomach. If this is too much work, you can just take an antacid tablet(Tums, Rolaids) and suck on one for a bit. You don't have to finish it and one tablet can do for half a dozen episodes of heartburn.

A common condition that makes people, especially old people, more susceptible to heartburn is "hiatus hernia." This occurs when a defect in the diaphragm allows the esophagus to slide up and down through the diaphragm. The esophagus normally cannot do this. The only real problem with this type of hernia is an increased tendency for stomach acid to get into the esophagus. As a consequence millions of people take antacids and drugs that reduce stomach acid. Do they do much good? Since the problem is not the stomach acid itself, but its presence in the esophagus, I doubt it. I take that back; if you are the person who sells or advertises those drugs, they will do you a lot of good.

As I've said, it takes just a little bit of bicarb to neutralize the acid in the esophagus. What happens if you take more than just a little bit? If you mix bicarbonate with acid, you neutralize the acid and produce carbon dioxide. While it is not enough carbon dioxide to affect global climate, it can be enough to produce gas in the stomach. The more bicarb you take, the more gas you make. Make enough gas and you can relieve the bloating with a good burp. You can also take medicine for gas which puts more money in the pockets of the people who make and sell the drugs and the people who successfully advertise them. The gas may also push some more acid into the esophagus.

What can be done for heartburn? A number of things. For one, don't eat foods that cause it. By now you should know what they are. Don't eat big meals. If you need a lot of food, spread it out. And most important, don't eat before going to bed. Give the food that you had for dinner time to leave your stomach. Sleeping on my right side seems to help me a bit. Since you can't sleep on my right side, that isn't going to help you.

There is an old medical adage that if doing something hurts, don't do it. I watch those TV commercials, when I'm not quick enough on the "mute" button, where people are eating and complaining about heartburn. If they knew that a particular dish caused heartburn, why didn't they eat something else? It may come as a surprise to some, but it is possible to live a good life without chili peppers. Is overeating worth the price? You be the judge.

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