No Vacancy At Heartburn Hotel

When’s the last time you sat down to a leisurely dinner with the family? Nowadays, that seems like a fantasy from Norman Rockwell.
Americans eat on the run. With pressure to work late, lots of after-school activities for the kids, committee meetings and exercise, there’s rarely enough time to sit down together even if there were time to cook.
We gobble down burgers or pizza from fast food joints or “grab and go” with supermarket sushi. It’s hardly any wonder that indigestion is a national affliction.
For many, treating heartburn has become a way of life. It used to be simple and cheap. Half a teaspoon of baking soda in a glass of water offered fast relief from stomach upset.
Those who wanted a store-bought remedy could choose Alka-Seltzer, Tums, Rolaids, Maalox or Mylanta. These familiar antacids were medicine chest staples.
Nowadays Americans spend billions on a vast array of sophisticated stomach medicine. There are so many options, both prescription and over the counter, that making a cost-effective choice is a challenge.
Twenty years ago, prescription acid suppressors like Tagamet, Zantac and Pepcid revolutionized the treatment of ulcers. When they lost their patents, these drugs went over the counter to compete head-to-head with old-fashioned antacids. Patients had to decide whether to purchase Zantac 75 instead of Tums or Maalox.
Simultaneously, doctors turned to more powerful prescriptions such as Prilosec and Prevacid. These “proton pump inhibitors” (PPIs) are very effective at suppressing acid, but at a steep price. Prilosec ran over $4 per pill, and in its heyday grossed about $4 billion annually.
Now that Prilosec, too, has lost its patent, the company has decided to cash in on its brand name recognition. Prilosec OTC will become available within weeks. Although the dose is the same as the prescription pill, it will cost significantly less. But at about $30 for 42 pills, it will be way pricier than Tums, which goes for about $4 for 150 pills.
So, what’s a patient to do for heartburn or indigestion? Some may badger their doctors for a prescription for Nexium, the “Purple Pill,” while others will ponder the benefits of Prilosec OTC versus Pepcid AC.
Doctors can also prescribe Prevacid, Protonix or Aciphex, competitors to Nexium. They are indicated for acid reflux, although distinguishing between “sour stomach,” indigestion, heartburn and GERD can be tricky.
To cut through some of the confusion, we offer our Guide to Digestive Disorders, with information on the pros and cons of various approaches to heartburn. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. G-3, P. O. Box 52027, Durham, NC 27717-2027.
Does it even make sense to treat heartburn? Aside from the discomfort, acid reflux can scar the esophagus, leading to more serious problems. That’s why no one should rely on Prilosec OTC indefinitely without seeing a physician.
But what about eating more sensibly? If we could avoid the temptations of fast food and faster snacks, some of the heartburn that troubles us might not need treatment at all.