Efficacy of low-dose antacids in the treatment of peptic ulcers: pharmacological explanation?

Antacids have been used as remedies for benign gastroduodenal disorders for centuries. They were regarded to be effective in relieving gastric pain and symptoms of hyperacidity and in promoting ulcer healing. The effectiveness was based on empiric observations and was not derived from the controlled clinical trials data. Until the introduction of histamine H2-receptor antagonists into peptic ulcer therapy, they dominated that field together with carbenoxolone. The enthusiasm for and euphoric attitude of gastroenterologists all over the world to H2-receptor antagonists resulted in a life of shadow for antacids. This changed when Peterson et al. published the first controlled clinical trial on Maalox (N Engl J Med 1977;267:341-5). (The use of trade names for antacids is justified as most of the antacids in use are composed of at least two if not more constituents).