Use of antacids, alginates and proton pump inhibitors: a survey of the general Danish population using an internet panel

Scand J Gastroenterol. 2014 Sep;49(9):1044-50. doi: 10.3109/00365521.2014.923504. Epub 2014 May 30.


Objective: Both over-the-counter medicine, such as antacids or alginates, and proton pump inhibitors (PPI) are used for treating acid-related disorders. We sought to describe what characterizes users of these different medicines, including long-term PPI users within the general population.

Method: A cross-sectional survey was conducted in an internet panel representative of the Danish adult population in 2012. Data queried included antacid/alginate and PPI use, reason for therapy, co-medication, and presence of upper gastrointestinal symptoms. Long-term PPI use was defined as using PPI ≥1/3 of the last year (∼120 days). Risk of long-term PPI use was estimated by logistic regression.

Results: A total of 18,223 people received the questionnaire, of which 52% (9390) responded. Antacid/alginate use was reported by 23%; 16% reported use of only antacid/alginate. PPI use was reported by 13.6%; 6.2% were defined as long-term PPI users. Antacid/alginate users were younger, used less co-medication, had most often started on therapy because of reflux symptoms, and had less often ongoing symptoms. Risk of long-term PPI use appeared to be increased in male gender, by renewing PPI prescription by phone/e-mail, using co-medication, and having started on PPI for several reasons. Combination of antacid/alginate and PPI was reported by approximately 50% of those on therapy with weekly or daily symptoms.

Conclusion: 23% of Danish adults were using antacids or alginates and 14% were using PPI, of which one-half were on long-term therapy. Prescription renewal by phone or e-mail and use of other prescription medication were associated with long-term PPI use, indicating a behavioral pattern, in which unnecessary PPI therapy may be maintained.

Keywords: alginate; antacid; dyspepsia; general population; internet panel; over-the-counter medicine; proton pump inhibitor; reflux.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Alginates / therapeutic use*
  • Antacids / therapeutic use*
  • Cross-Sectional Studies
  • Denmark
  • Drug Prescriptions / statistics & numerical data
  • Drug Therapy, Combination / statistics & numerical data
  • Female
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / drug therapy*
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use*
  • Sex Factors
  • Surveys and Questionnaires
  • Time Factors


  • Alginates
  • Antacids
  • Proton Pump Inhibitors