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COPYRIGHT 2002 Consumers Union of the United States, Inc.
From the old "plop plop, fizz fizz" Alka-Seltzer ads to recent commercials for Surpass antacid gum with animation reminiscent of Monty Python's Flying Circus, marketers have long been making light of heartburn. They've portrayed the need for Tums or Rolaids after a big meal as a comical annoyance of middle age.
Most heartburn is indeed minor, but it's still no laughing matter. Nearly half of all U.S. adults suffer at least one attack per month. Chronic heartburn--more than one attack per week--is particularly serious, since it can lead to asthma, bronchitis, pneumonia, even cancer.
Treating heartburn can be a major headache for consumers, who face a bewildering array of over-the-counter and prescription remedies, including relentlessly advertised drugs. Last year, the prescription heartburn drug esomeprazole (Nexium), "today's purple pill," ranked third in money spent on direct-to-consumer ads. But esomeprazole is almost identical to its predecessor, omeprazole (Prilosec), which ranked second in such spending in 2000, before its patent ran out.
While both drugs are effective against chronic heartburn, they're expensive and require prolonged use. Other, less costly drugs may prevent chronic attacks. And most sufferers, who have occasional attacks, usually need only simple antacids.
To clarify the choice of antacids, we tested 16 top-selling products in a special glass "stomach." (See "Test, Inform, Protect" on page 6.) While all the products started neutralizing stomach acid rapidly, we found major differences in how long the simulated relief from a maximum dose would last. Mylanta Ultra Tabs kept the acidity in the comfort zone for more than two hours; at the low end, two products lasted only half an hour or so. Further, our taste tests of the eight longest-lasting antacids will help guide you to the most palatable products, such as Tums Extra Strength Cool Relief Calcium with Friva Crystals, which tasted like a breath mint.
This report will also help heartburn sufferers decide when to seek a stronger medication, when to see a doctor, and when to consider screening for possible heartburn-induced cancer.
CAUSES AND CURES
A thick lining of mucus protects the stomach from its own digestive acid. But the esophagus--designed as a one-way tube from the mouth to the stomach--has no such protection. A ringlike muscle, or sphincter, at the bottom of the esophagus normally prevents acid backup by relaxing only when food or drink is swallowed. In some people, that muscle slackens at the wrong times or closes incompletely, letting acid back up into the esophagus. Such backup, called gastroesophageal reflux, can cause heartburn, typically a burning sensation under the breast bone.
Making lifestyle changes, notably, avoiding certain foods and drinks, may help control heartburn (see box at right). For occasional attacks, two kinds of medication can provide relief:
Antacids. These work by neutralizing acid. In our tests, antacids started acting within a minute or so and thus are best for treating an attack that's under way. While many products worked long enough to outlast most attacks, others might well wear off prematurely. (See Ratings on page 45.)
[H.sub.2] blockers. These prevent a key substance in the body from stimulating acid production. Nonprescription [H.sub.2] blockers prevent heartburn for up to 10 hours. But they take up to an hour to start working, so they're the best choice if you remember to take them before you're about to eat a meal that's likely to trigger an attack.
Pepcid Complete combines an antacid...
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