More Blockbuster Drugs for Ulcers: Prilosec, Nexium, and Other Proton-Pump Inhibitors
In the first half of the 19th century, British physician William Prout conclusively showed that gastric juice contains hydrochloric acid. U.S. Army officer William Beaumont examined the physiological control mechanism of gastric acid secretion by studying Alexis St. Martin’s chronic gastric fistula that had resulted from a gunshot wound in the 1820s. Gastric acid is essential to digest protein and emulsify fats. It breaks down food so it can go on to the small intestine where nutrients are absorbed. Low levels of gastric acid can contribute to a myriad of discomforts and diseases. On the other hand, too much of a good thing is bad. High levels of gastric acid often result in heartburn and ulcers. Heartburn is a symptom produced by reflux when digesting food and gastric acid passes back up into the esophagus through the sphincter muscle at the top of the stomach. It is also known as GERD, for gastroesophageal reflux disease. If reflux occurs often and the body fails to sufficiently clear the acidic mixture back into the stomach, the tissue of the esophagus can be damaged, and that is when ulcers develop. Forty million Americans experience heartburn two days a week, and 60 million have it at least once a month. The disorder costs an estimated $10 billion in the United States, counting visits to doctors and hospitals, medications, and time lost from work, according to the American Gastroenterology Association. Before the emergence of Tagamet and Zantac as H2 histamine-receptor blockers for the treatment of heartburn and ulcers, numerous medicines were available, but none were satisfactory. For over a century, heartburn sufferers had been taking over-the-counter (OTC) antacid products such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Tums. Most of them contain simple inorganic bases as the principal active ingredients. Americans alone spend approximately $1 billion a year on these antacids, which bring relief within minutes and work by neutralizing the stomach acid that causes heartburn.