Antacids - good or bad?

[Pan]

I'm sure all of us have upset stomachs from time to time. I've had trouble with mine lately. I have RiteAid's version of Tums, essentially: 750 mg of calcium carbonate per pill plus various more or less annoying additives. It's generally considered that moderate intake of calcium supplements is beneficial. However, there's a warning on the back of the bottle:

When using the product do not take more than 10 tables in a 24-hour period, or use the maximum dosage of this product for more than 2 weeks, except under the advice and supervision of a doctor

Last night and this morning, I've been tempted to exceed that dosage, but I don't think I will. The reason is that calcium carbonate has side effects:

The presence of other medical problems may affect the use of antacids. Make sure you tell your doctor if you have any other medical problems, especially:

[...]

# Constipation (severe and continuing) or

# Hemorrhoids or

# Intestinal blockage or

# Intestinal or rectal bleeding—Antacids may make these conditions worse

Yep, in the last few days, I've had rectal bleeding and painful defecation no matter how much Metamucil I've taken.

Inflamed bowel—Use of antacids may cause the body to retain (keep) water and electrolytes such as sodium and/or potassium

Uh-huh.

I'm wondering whether it's possible to develop a harmful dependency (note that I didn't say "addiction"!) on antacids. For now, I think I'll avoid ingesting anything but water, and I may well fast for the day.

[fifi]

I think the message is moderation. Too much of anything can cause problems. There are also some drug interactions that have to be attended to. I have had antibiotics that warn against taking antacids because they will deactivate the antibiotic.

I am lucky that I don't have too many stomach problems. One that I do have to avoid is any tomato product foods too late in the evening. I get really bad "heartburn" from that so I just avoid it. (That is a real pain when I get pizza munchies.)

I eat a couple of Tums a day for the calcium. I can't seem to swallow Citrical without gagging. But I try to do that in between meals.

Drinking water is a very good thing to do. I drink at least a couple of quarts a day. I have been driven to do this for the past 20 years in order to keep my kidney stones well bathed and happy. I attribute this water consumption to my relative lack of digestive problems even with my erratic eating habits.

[NulloModo]

I used to have huge indigestion problems. When I did I would frequently turn to Tagamet HB or whatever the Costco Berkeley and JEnsen ripoff is, they both had the same effect: which was to kill the acid reflux immediately. One pill pretty much handled everything, not sure how they relate to other antacids as far as dependency though...

However, since pretty much eliminating carbonated beverages from my diet the problems have just completely gone away, no matter how much spicey stuff I eat, so, I'll just stick with what I am doing now.

[johnnyd]

The problem with TUMS related products that include Calcium Carbonate is that you need to have a certain amount of acid available for Calcium to be properly absorbed into the system. This makes Anti-acids with calcium a big joke.

The best calcium supplement is usually a dissolvable powder with ascorbic acid, cacium gluconate and magnesium carbonate (2:1, calc to magn is best). This is an orange flavored drink powder, available in some drugstores.

As far as indigestion, every year you lose a certain percentage of enzymes that help digest foods (amylase, protease, etc) making some big dinners a real drag the older you get. I've been taking an enzyme supplement for five years and I haven't had a problem since... Okay, two pots of coffee at a stretch does not help anything, nor does ten pints of micro-brew ale in a row, but you get the picture.

[Pickles]

The presence of other medical problems may affect the use of antacids. Make sure you tell your doctor if you have any other medical problems, especially:

[...]

# Constipation (severe and continuing) or

# Hemorrhoids or

# Intestinal blockage or

# Intestinal or rectal bleeding—Antacids may make these conditions worse

Yep, in the last few days, I've had rectal bleeding and painful defecation no matter how much Metamucil I've taken.

I think you should go see a doctor and quit self-medicating. If you're in pain, eating antacids, and have other serious symptoms--like the bleeding, common sense should tell you this. Feel better soon.

[Susan G]

I'll second Pickles's advice: Rectal bleeding is something for which a doctor needs to be called. Tell the receptionist *specifically* that you have this problem when you call - -the doctor may have special hours for emergent conditions.

[mighty quinn]

agree wholeheartedly with pickles- GERD (gastroesophageal reflux disease) is very common but gerd symptoms may mask other disease states- gastric cancer, hiatal hernia. chronic gerd that is self treated inappropriately may lead to more problems. the primary treatment for gerd is lifestyle change-quit smoking, cut back/eliminate caffeinated bevs, cutback/eliminate alcohol intake, and then there's the biggy---FAT! otc meds such as h2 blockers are "safe as water" when it comes to treating the occaisional "i really over-did-it heartburn," but any persistance of symptoms greater than 7- 14 days needs to be evaluated by a healthcare provider. otc meds such as tums or mylanta offer temporary relief from heartburn by simply neutralizing acid in the stomach. good luck with the gerd!!

[FistFullaRoux]

Those of us with gastric reflux or hiatal hernias feel your pain. But bleeding is not normal. Get thee to a doctor.

Without getting too graphic, if it's red, it's probably external, if you can control the bleeding, it may be able to wait for you to get a doctor's visit. You may be looking at a hemmorhoid (well, not really looking at it, but you get what I'm saying). If the stool looks black like tar, then it is internal, and that requires an emergency room, ASAP.

[Pan]

No, it's not black. Don't get overly worried, folks, this problem has been intermittent and my doctors know about it. I won't make an appointment unless it continues for another week or so or worsens. Besides, today is Saturday, so no doctor.

[dumplin]

I've had GERD because of meds my doctor gave me in college. Tums didn't do anything for me. (especially after I was forced to eat taco salad at my future in-laws ) Gaviscon worked well for me. I had an upper and lower GI... my doctor also told me to start taking my meds in the morning, and when I did, a lot of the pain stopped. If you're eating a ton of Tums, you need something else that will do the trick. There are plenty of other meds that your doctor could help you choose.

My husband is going through the diagnosis process of GERD and ulcers. He's in for a suprise when the doctor tells him what he can't eat anymore. At least since I've had a lot of the symptoms I can help him with the pain until the doctor gives him something to help. Tums isn't it!

[franktex]

I was on Prevacid, which was a miracle drug for GERD. Now, the exact same drug is available OTC-it is called Prilosec OTC, and it is half the price of my perscription of Prevacid. Sam's is usually the best place to get it. It works! One a day, and yuou will never have to deal with it again.

[Pan]

I'll continue to eat really lightly, and if I still am having trouble, I'll look into that drug.

[jsolomon]

Pan: question of diet. Do you eat beets? They have *ahem* gi effects that can mimic bloody stools. If the answer is no, you haven't been eating beets, you really ought to make an appointment with your primary care physician. Or, if that isn't convenient, appraise your primary care physician of your current state and listen for advice as such.

But, if you're having painful stools and other issues, you are overdoing it on cations in your diet. My suggestion would be drop the RiteAid Tums-alikes and switch to baking soda in water for acute attacks. Sodium carbonate is much better tolerated by the body in such large amounts. But, it isn't intended for continued usage, either.

But, if you've had symptoms like this where you're eating Tums like they're candy for days, you have something going on that ought to be medically examined. My gut feeling leans toward gall-bladder.

My best advice as a medical professional with a decade of experience is: get thee to thy physician. Quickly. Wednesday would be good. Monday would be better. But, have your physician make sure that your gall bladder at the very least is still ticking.

[Pan]

Gosh, some of you are really alarmist. I wasn't asking for amateur diagnoses (assuming you're not a doctor; I forget whether you are one). If I'm no better in a couple of days, I'll speak with my doctor or his RN, whoever isn't currently on vacation.

Besides, the main cause is that I think I've been eating too much. I may have hit rock-bottom on that, too. Sooner or later, it's necessary for me to confront the disconnect that's developed between my real appetite and my eating habits. I think the time is now.

Edited July 25, 2004 by Pan (log)

[Rebel Rose]

Pan, sorry to hear of your discomfort! May I suggest activated charcoal? I've relied on it for twenty years, always keep it in the house, carry it on travels, and it's comforted my son through many gastrointestinal distresses. It is completely natural, works quickly, and has no side effects. You can take 2 capsules after every meal, but you probably won't need to as it's very effective. And $5 for 100 capsules. (Just don't burp after taking it, or you'll expel a little black cloud! )

Here's a link to iHerb.com, where I do most of my vitamin shopping.

Some liquid acidophilus culture might be helpful, too. I prefer the strawberry flavor by Continental.

I hope you feel better soon!

[jsolomon]

Gosh, some of you are really alarmist.

Air goes in and out. Blood goes round and round. Any deviation from this is not how we are supposed to live.

I don't think that I'm being alarmist, though. If your blood is not in your pipes, and you can't explain why it is not in your pipes, you need to have it checked out.

I'm not attempting to diagnose, but you've got pain where you should have a relaxing elimination experience, and you've got blood where you can't see it expressing. Those are not good signs of adequate health.

Edit to add: if you search google for "calcium toxicity symptoms" you're going to get lots of cruft of unknown quality. I'd trust your primary caregiver.

Edited July 25, 2004 by jsolomon (log)

[tryska]

ease off the calcium and switch to magnesium for a few days.

also rather than treating the symptoms of the acid - might be good to find the underlying cause (food intolerances/allergies and whatnot)

[curlywurlyfi]

what about something soothing for your digestive tract, like peppermint tea or (my preference) fennel tea? am not suggesting for one minute that these are alternatives to medical help, but they can be palliative. Drink warm rather than hot hot hot, and feel better soon.

Fi

[Pan]

Since this thread became at least as much about me as about antacids, I want to give you all an update. After a weekend of near-fasting, eating almost nothing except a bit of Metamucil Cinnamon Spice Fiber Wafers, drinking some tea (peppermint + chamomile, in addition to my usual hibiscus) and plain water (and ultimately, last night, high-pulp orange juice), and using several Calmol 4 suppositories, I am doing much better. After having eaten no actual food in well over 24 hours, I felt good enough - and hungry enough - to have a breakfast of a spinach/mushroom/swiss cheese omelet with a side of beets that I didn't finish (some are left for a snack later) this morning. I'm no longer bleeding but will continue with the suppositories for at least this day.

The problem, as I said, was that I just put way too much into my stomach Friday night. It was a really awful experience! I've learned a lesson from it and intend never to stuff myself that much ever again.

Unfortunately, I got onto a bizarre waking and sleeping schedule and was again unable to sleep all night and all morning (I'm on vacation and don't have to be anywhere in particular today). But I definitely feel a lot more normal, and I think my gallbladder is in its normal place.

Thanks to all who expressed concern and gave suggestions.

P.S. The link I provided for side effects of calcium carbonate (Tums et al.) is an NIH page. Part of their website gives information about all sorts of medicines.

[bloviatrix]

Just remember the side effects of beets. Because if you forget you've eaten them the result can be un-nerving.

[chow guy]

agree wholeheartedly with pickles- GERD (gastroesophageal reflux disease) is very common but gerd symptoms may mask other disease states- gastric cancer, hiatal hernia. chronic gerd that is self treated inappropriately may lead to more problems.

I also agree, and have been treated for GERD for many years now. if you let symptoms go on for too long it can cause esophageal erosion which is a pre cancerous condition. Prilosec works amazingly well and I can pretty much eat anything (since it blocks the acid before heartburn has a chance to smolder).

[Pan]

Just remember the side effects of beets. Because if you forget you've eaten them the result can be un-nerving.

I know. But believe me, I know the difference between rectal bleeding and beet juice. If I didn't know it by appearance, the pain would be a sure tipoff...

[bloviatrix]

One other thought. In order to relieve some of the discomfort, you might want to add some stool softener to the Metamucil you're taking. Colace is the most common one found. What ever you do, make sure you don't buy the one with the laxative in it.

[Pan]

What do you mean, the one with the laxative in it? Psyllium fiber is itself a laxative. I'm not familiar with colace and may try to find out more.

[tryska]

actually psyllium is just fiber. the bulking action it has on the stool encourages peristalsis, but it doesn't stimulate the bowles directly.

magnesium can be a laxative tho, but it's a good way of balancing out the calcium in your body, since they are antagonists.