So i had a patient the other day who woke up around 6:30am requesting something for his reflux. (He has a hx of GERD, pretty well controlled). I checked the MAR to see what i could get him, he didnt have anything ordered. Doctors do their rounding at 7:00 so i told him to sit up in the chair and i would request something when doctors came for rounds.

I told the doc...patient requested a Tums, as that is what he normally takes when he needs it. The doctor said he wouldn't give him Tums (like the chewable quick acting) because he said the calcium carbonate actually can make acid secretion build up more, its only temporary relief. Patient did end up getting pepcid, but has anyone else heard this?? The patient asked me about it after the doc. left and said he has never heard that either and was told to take a tums by his family doc when he is having active reflux.

I think the clues there are "temporary relief" and "active reflux". I suffer from it and am using Nexiam (esomeprazole). Over the counter stuff like Tums can worsen it with long-term use. Although it's very bad that the family doctor didn't warn your patient of this, or put him on a recognized long term treatment.

Ca++carbonate is well known to give what called reflexive dyspepsia. That's why on the commercials for things like Zantac they tout how the relief comes quick and stays away rather than other "chewable" alternatives.

Personally it gives me extremely acrid eructations and then any reflux I had comes back just as bad if not worse a few hours later.

Ps - I'm not recommending any medications over any others, but the reflexive dyspepsia was explained to me as such: Your body realizes that the acidity isn't where it wants to be when the Ca++ carbonate starts working, and turns on MORE pumps to return pH back to where it wants to be, sometimes not turning these additional pumps back OFF right away. Hence worse than when you first started.

Whan I got diagnosed with GERD, my GI doctor told me "no quick fix medications". He was a firm believer in diet/lifestyle changes and short term protonix use while making said changes.

I was one of those people who had such bad heartburn for so long that I had forgotten going without it was like. After a few days on Protonix, I was amazed. I've quit tobacco and have avoided the enormous sized meals. Its much better. I can go weeks without taking the Protonix (and often do ) and not have an attack. Before, if I missed two days.........it was back.

He especially told me to avoid calcium carbonate. I didn't ask why though.

Yep... I learned this in chem. The neutralization is short lived and the body reacts by upping the ante.

My brother-in-law is a Dr. and told me and my hubby the same thing.

Right, that's why they sell those mega-bottles of Tums. It makes its own market. Don't get me started on Afrin.

Hmm..interesting. I honestly never really knew that. But i guess it makes more sense, where acidity isnt where its supposed to me so it makes more.

He was told by family practice to take Tums if it is really bothering him, but was perscribed omperazole for when he thinks he may need it. I dont think this doc ever explained why. Which i now see would be important to explain to patients, cause i could see patients over-using them just worsening their problem.

As posted above, it is not beneficial when used as a stand alone, because of the rebound effect. However, if nothing else is on board, it's not beneficial to let the attack run its course either. Gerd sufferers can often find a more natural way to alleviate sudden attacks.