Document Detail

Calcium carbonate antacids alter esophageal motility in heartburn sufferers.
MedLine Citation:
PMID:  15628717     Owner:  NLM     Status:  MEDLINE    
Chewed calcium carbonate (CaCO3) rapidly neutralizes esophageal acid and may prevent reflux, suggesting another mechanism of action independent of acid neutralization. Calcium is essential for muscle tone. Our aim was to determine if luminal calcium released from chewed antacids improved esophageal motor function in heartburn sufferers. Esophageal manometry and acid clearance (swallows and time to raise esophageal pH to 5 after a 15-ml 0.1 N HCl bolus) were performed in 18 heartburn sufferers before and after chewing two Tums EX (1500 mg CaCO3, 600 mg calcium). Subjects with hypertensive esophageal contractions or hypertensive lower esophageal sphincter pressure (LESP) were excluded. Subjects with normal to low LESP were included. Differences between parameters were determined by two-tailed paired t-tests, P < 0.05. Proximal esophageal contractile amplitude was significantly increased after CaCO3 (47.18 vs 52.97 mm Hg; P = 0.02), distal onset velocity was significantly decreased after CaCO3 (4.34 vs 3.71 cm/sec; P = 0.02), and acid clearance was significantly increased 30 min after CaCO3 (20.35 vs 11.7 swallows, [P < 0.005] and 12.19 vs 6.29 min [P < 0.007]). LESP was not altered after CaCO3 (22.70 vs 23.79 mm Hg; P = 0.551), however, LESP increased in 9 of 18 subjects. Depth of LES relaxation, medial and distal esophageal contractile amplitude, and duration of contractions were not altered by CaCO3. CaCO3 did not alter salivary secretion and pH in a subset of these subjects, and CaCO3 with secreted saliva did not neutralize a 15-ml acid bolus. The Ca2+ released after chewing of CaCO3 antacids may be partially responsible for the reduction of heartburn by significantly improving initiation of peristalsis and acid clearance.
Sheila Rodriguez-Stanley; Tanveer Ahmed; Sattar Zubaidi; Susan Riley; Hamid I Akbarali; Mark H Mellow; Philip B Miner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  49     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2005-01-04     Completed Date:  2005-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1862-7     Citation Subset:  AIM; IM    
Oklahoma Foundation for Digestive Research, Oklahoma City, Oklahoma 73104, USA.
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MeSH Terms
Antacids / therapeutic use*
Calcium Carbonate / therapeutic use*
Esophagus / drug effects*,  physiology
Heartburn / drug therapy*
Hydrogen-Ion Concentration / drug effects
Middle Aged
Peristalsis / drug effects*
Prospective Studies
Reg. No./Substance:
0/Antacids; 0/Tablets; 471-34-1/Calcium Carbonate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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