Health: Got A Bad Gut Feeling? The low-down on heartburn and the drugs to cure it.(Brief Article)

Byline: Anne Underwood

After 40 years as a truckdriver, Cecil Albertson is pretty tough. But three years ago he began to dread going to sleep at night. When he lay down, says the 77-year-old Albertson from Blue Springs, Mo., stomach acid would back up into his throat. His doctor told him to take Rolaids, but the problem only got worse. Then a gastroenterologist diagnosed his condition as reflux disease and switched him to a prescription drug called Aciphex. Now he's sleeping soundly.

You may not have heard of reflux or some new prescription antacids like Aciphex. But chances are, if you've read a magazine or watched TV lately, you've seen ads for similar drugs, including Prevacid, Protonix and those "purple pills" (as the ads call them), Prilosec and Nexium. Last year these drugs racked up sales of $10.2 billion, second only to cholesterol-lowering statins. Nearly 75 million prescriptions for these medications were dispensed in 2001. Some HMOs now balk at covering the pricey pills--costing as much as $8 a day--and suggest they're overprescribed. The drug companies counter that ads have merely raised awareness of a condition. Who's correct--and when do you really need the pills?

The cause of most chronic heartburn is gastroesophageal reflux disease (GERD). Normally, when a person swallows, the muscle at the bottom of the esophagus opens to allow food into the stomach. But the muscle can weaken, letting food and acid back up, particularly when a person is lying down. Chronic exposure to acid can inflame the esophageal lining and may even lead to a precancerous condition.

Drugs like Prilosec and Prevacid inhibit the formation of stomach acid and are most commonly prescribed for GERD. Given the increase in prescriptions, one might think GERD is on the rise. But according to Dr. Prateek Sharma of the American Gastroenterological Association, it's remained fairly constant over the last 30 years, with 20 percent of the adult ...