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Your stomach can be a battleground


Indigestion is as American as hot dogs and apple pie. And no wonder, when you consider our national eating habits.

What we do to our stomachs is a sin. We gulp down coffee and Danish on the run in the morning. At lunch we drive through for burgers, fries and shakes. To top it off, pepperoni pizza and beer before bed can take a toll on your tummy.

It's hardly any wonder that we spend billions trying to treat heartburn. Antacids are a staple in medicine chests across the country. And such acid-suppressing prescription drugs as Zantac, Tagamet, Pepcid and Prilosec are among the biggest sellers in the drug store.

The stomach is actually quite resistant to injury from acid and other digestive juices. A lining of mucus coats the stomach like jelly and keeps that acid away from sensitive tissue. The esophagus, however, is vulnerable to acid injury. If the sphincter (ring of muscle) separating the food tube from the stomach gets lazy, irritating stomach contents can splash back into the esophagus. That's how heartburn starts.

Many foods and drugs can set the stage for heartburn by relaxing the sphincter. Coffee, alcohol, nicotine, mint, chocolate, onions and fried foods are notorious offenders. Asthma medicine such as theophylline, the female hormone progesterone and the anti-anxiety agent diazepam (Valium) may also relax the muscle.

Although there is now a prescription drug called Propulsid (cisapride) to tone up the sphincter, most physicians still recommend antacids or acid-suppressing drugs like Zantac.

Which antacids are best? Aluminum and magnesium combinations have generally been top rated. A recent review by Consumers Union found Mylanta Double Strength in Cherry Creme, Mint Creme and Original flavors came out best, together with Maalox Plus Extra Strength. All four provided long lasting (over 100 minutes) acid-neutralizing power.

These are excellent choices for short-term indigestion. But people who rely on antacids regularly may want to be aware that there is controversy surrounding aluminum-containing products. Experts for Consumer Reports point out that "long-term use of aluminum antacids can rob the body of calcium, weakening bones."

Calcium antacids, on the other hand, can kill two birds with one stone. Not only do products like Extra Strength Rolaids or Tums E-X Extra Strength ease heartburn reasonably well, they also supply calcium, a mineral many Americans need more of.

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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