Q. At long last, let’s get on to the standby therapy of the past fifty years or more — antacids. What is their current status in ulcer treatment?

A. I’m glad you mentioned them, for the current reaction to them is a mixed one. For many years they have been the sheet anchor of therapy, but mainly by default rather than because of their intrinsic worth.

There is little doubt that they will reduce ulcer pain. However, as far as healing is concerned, evidence indicates that very large doses are required. According to a leading Sydney gastro-enterologist who has treated ulcers for many years, “when given in high dosage (equivalent to 30 ml double strength aluminium hydroxide gel one hour before and after each meal and also before retiring), antacids have also been shown to be effective in treating peptic ulcers. Liquid antacids are generally more effective than tablet formulations, but are less convenient for the working person.”

Q. Could taking all that medication each day in itself produce unpleasant side effects?

A. It seems this is possible and many patients on high doses may develop diarrhoea or constipation. Also, long term, a condition called ‘hypophosphataemia’ with anorexia (loss of appetite), muscular weakness, and a bone condition called osteomalacia may take place, if used in high doses over prolonged periods of time. Other side effects are also possible, depending on the type of antacid used. One case was recently reported in the medical journals of a patient with very large bladder stones which had developed after many years of taking a calcium antacid.

However, there is little doubt that used with discretion, and under proper supervision, antacids can bring a good deal of symptom relief. They are cheap, readily available and, in smaller doses, may do little harm, even if they are not as dramatically beneficial as some of the newer forms of medication. The antacids are available in many forms, as mixtures, tablets, powders. Many patients will continue using them, especially if there is occasional abdominal discomfort. What’s more, they often help in simple cases of dyspepsia, a feeling of fullness, bloat, and the unpleasant sensation which commonly follows from ‘dietetic indiscretions’, as the doctors succinctly put it.


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