I've noticed that you recommend antacids for heartburn, but you do not
mention Tums or Rolaids. Aren't these good antacids? In addition to their
acid-neutralizing effects, aren't they also good as sources of calcium?
Gastroenterologists generally do not prescribe calcium carbonate-containing
antacids such as Tums or Rolaids. The reason for this is
a phenomenon called acid-rebound. Calcium carbonate-containing antacids,
unlike other over-the-counter antacids, stimulate the release of gastrin
from the distal stomach and duodenum. Gastrin is the hormone primarily responsible for the
stimulation of acid secretion by the stomach. After the direct acid-neutralizing
effects of the calcium carbonate are exhausted, the secretion of acid
rebounds due to the release of gastrin, and there is an overproduction of
acid. Theoretically, this is not good for the stomach and duodenum.
Acid rebound has not been shown to be clinically important, that is, it has
not been shown that treatment with calcium carbonate is less safe than treatment with antacids
not containing calcium carbonate. Nevertheless, the phenomenon of acid rebound
has been well-documented and is potentially harmful. In practice, the occasional use
of calcium carbonate-containing antacids probably is not harmful. One
advantage of calcium carbonate-containing antacids is their low cost.
Another is the additional calcium that they provide, though there are
other sources of calcium. Could calcium carbonate-containing antacids be
bad for people who take them for calcium supplementation? It's unknown, no
one has raised the issue, and there are no reports of problems.
Last Editorial Review: 7/19/2002
Thank you for your question.
Jay W. Marks, M.D.