Among the commonest ills of man, ranking close to constipation and headaches, is the wide range of supposed digestive upsets mistakenly described as "acid indigestion." Every day, millions of Americans complain of "heartburn" or "sour stomach." TV commercials spiel endlessly about "acid upset." Some sufferers try to dignify their complaints with such technical terms as hyperacidity and acidosis. By whatever name, the problem is a high-up bellyache, and those who suffer from it in the U.S. lay out $90 million each year for antacids and alkalizers.
Haunting Danger. Medically both heartburn and acid indigestion are vague terms, as hard to define precisely as to treat effectively. Heartburn ("pyrosis" in medical jargon) is a burning sensation felt somewhere behind the breastbone. In the vast majority of cases, the pain means only that the victim cannot digest food properly because he is emotionally upset, and he may have the pain without food. But there is always the haunting danger that what feels like heartburn may be nature's warning that the coronary arteries are shutting down. Many a man has died of a heart attack soon after asking for a glass of sodium bicarbonate.
Another serious condition that can be mistaken for simple heartburn is a hiatus hernia—a defect in the diaphragm where the gullet (esophagus) passes through, just above the stomach. This permits part of the stomach to poke upward into the chest cavity and spill digestive juices into the gullet. Pope Pius XII suffered from a hiatus hernia for a long time before it was correctly diagnosed and treated, and the condition is by no means rare.
Often, however, heartburn comes with a backflow of partly digested food from the stomach into the esophagus. The victim may then belch up a little of this undigested food or its juices, and be concerned by the sharp taste of his "sour stomach." In most cases, this is a minor matter, and the result of gulping food while under emotional tension. A classic case is that of Wall Street brokers, who eat on their feet during midday trading. The cure is to stop eating, which is easy, and to calm down, which is not. Antacids may speed relief.
Flowing Juices. What seems to be acid indigestion, usually with nausea and belching, has the same causes as heartburn. An antacid tablet may help. The catch is that the layman usually cannot tell the difference between this and a medically significant form of indigestion. This inflammation of the stomach (gastritis) is part of the pattern of peptic ulcer. Then the trouble is not a simple backup of the evening's Scotch, steak and potato but a too-free flow of hydrochloric acid and other digestive juices from the stomach walls into the stomach itself and the duodenum. The excess juices find a vulnerable spot in the stomach wall or duodenum and, in effect, digest that. The result is an ulcer.