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From: rck@med.unc.edu (Ron Knight)
Newsgroups: alt.folklore.urban
Subject: Stomach rupture from baking soda
Date: 8 Jul 1994 05:24:31 GMT

The FAQ sez:

F. Taking baking soda as an antacid is bad 'cause CO2 can rupture your

stomach.

The latest issue of _Consumer Reports_, in their article evaluating antacids, repeats this advice, saying that in cases in which there has been gross overeating and the stomach has been severely extended, taking baking soda as an antacid can indeed generate enough carbon dioxide to rupture the stomach. I did a Medline search and came up with 5 publications, all indicating that the F in the FAQ should be changed to a T. The abstracts given here for the last two are particularly clear.

Document 1
AU Downs-N-M. Stonebridge-P-A.
IN Department of Surgery, Royal Infirmary, Edinburgh. TI Gastric rupture due to excessive sodium bicarbonate ingestion. SO Scott-Med-J. 1989 Oct. 34(5). P 534-5.

Document 2
AU Tonetti-F. Gorini-P.
TI [A case of stomach rupture after ingestion of sodium bicarbonate]. TT Un caso di rottura dello stomaco dopo ingestione di bicarbonato di sodio. SO Minerva-Chir. 1988 Oct 31. 43(20). P 1737-9.

Document 3
AU Barna-P.
TI Sodium bicarbonate: burst stomachs and high sodium [letter]. SO J-Clin-Gastroenterol. 1986 Dec. 8(6). P 697-8.

Document 4
AU Lazebnik-N. Iellin-A. Michowitz-M. TI Spontaneous rupture of the normal stomach after sodium bicarbonate

ingestion.
SO J-Clin-Gastroenterol. 1986 Aug. 8(4). P 454-6. AB Spontaneous rupture of the normal stomach is an unusual and highly lethal

     event.  We present a case of spontaneous rupture of a normal stomach
     after ingestion of sodium bicarbonate, and review the seven similar cases
     previously reported.  Author-abstract.

        Document 5

AU Brismar-B. Strandberg-A. Wiklund-B. TI Stomach rupture following ingestion of sodium bicarbonate. SO Acta-Chir-Scand-Suppl. 1986. 530(). P 97-9. AB Spontaneous rupture of the stomach is an uncommon condition with a

     usually poor prognosis.  The rupture occurs as a result of a closed loop
     obstruction with increased pressure against the stomach wall.  A case of
     stomach rupture occurring after hyperdistention of the stomach following
     ingestion of sodium bicarbonate is described and the pathophysiological
     mechanism is discussed.  Author-abstract.

Ron "and for God's sake, don't add vinegar" Knight

From: kdq@trans.jpl.nasa.gov (Kevin D. Quitt)
Newsgroups: alt.folklore.urban
Subject: Re: Stomach rupture from baking soda
Date: 8 Jul 1994 07:37:04 -0700

Thus wrote rck@med.unc.edu (Ron Knight) >The FAQ sez:
>F. Taking baking soda as an antacid is bad 'cause CO2 can rupture your
> stomach.
>The latest issue of _Consumer Reports_, in their article evaluating
>antacids, repeats this advice, saying that in cases in which there
>has been gross overeating and the stomach has been severely extended,
>taking baking soda as an antacid can indeed generate enough carbon
>dioxide to rupture the stomach. I did a Medline search and came
>up with 5 publications, all indicating that the F in the FAQ should
>be changed to a T. The abstracts given here for the last two are
>particularly clear.

You should also point out that (as I recall from the article), there have been 5 or 6 cases in the last 60 years.

From: rrd@fc.hp.com (Ray Depew)
Newsgroups: alt.folklore.urban
Subject: Re: Stomach rupture from baking soda
Date: 8 Jul 1994 22:21:50 GMT

Look what I found in my personal file!

                Copyright 1991 The New York Times Company  
                               The New York Times

               November 27, 1991, Wednesday, Late Edition - Final

SECTION: Section C; Page 8; Column 4; National Desk; Health Page

LENGTH: 857 words

HEADLINE: In Rare Cases of Indigestion, Baking Soda May Be a Peril

BYLINE: By WARREN E. LEARY, Special to The New York Times

DATELINE: WASHINGTON, Nov. 26

BODY:
Baking soda, like aspirin, bandages and rubbing alcohol, has been a staple inmedicine cabinets for more than a century. Over that time, billions of doses of sodium bicarbonate have followed holiday feasts, spicy foods or samplings of unusual recipes into the digestive systems of the nation.

Few people report adverse effects from the common household chemical. But ingesting it has been associated with scattered cases of stomachs bursting, presumably because of carbon dioxide gas the compound releases into the digestive organ when it is unusually full.

"I nearly died after taking this stuff," said William Graves, who suffered a rupture through the wall of his stomach in 1979 after taking baking soda mixed in water for indigestion after a big meal. The 64-year-old resident of Bethesda,Md., who is editor of National Geographic Magazine, said that only emergency surgery saved his life and that six more operations were needed to repair the damage.

Rupture of Stomach

He said the incident occurred while he was on vacation after an evening when he consumed two vodka martinis, a bowl of chili with corn chips on the side, a salad, corn bread, a glass of red wine, cookies and an after-dinner brandy. Soon after going to bed, he awakened with indigestion and mixed a teaspoon of baking soda with a small amount of water. Less than a minute after drinking it, he said, he collapsed in agony when a two-and-a-half-inch rupture occurred in the inner curve of his stomach.

He sued Church & Dwight Inc., of Princeton, N.J., whose Arm & Hammer Division is the nation's main supplier of the compound. The suit contended that the product did not carry adequate warnings and asked that baking soda be removed from the market as an antacid.

A Superior Court jury in New Brunswick, N.J., decided on Oct. 4 that labeling on baking soda at the time of the incident was inadequate, but did not conclude that the chemical had caused Mr. Graves's stomach problems and declined to award any damages.

Both sides claimed victory after the trial. "We won on the point that the label should have warned about the danger of stomach rupture," Mr. Graves said. Dwight Minton, chairman of Church & Dwight, said, "This has been in common use for hundreds of years, and literally hundreds of millions of people have used baking soda products in billions of cases of indigestion with few reported ill effects."

The Food and Drug Administration has been reviewing the uses of sodium bicarbonate as part of its program to examine older nonprescription drugs listedas "generally regarded as safe." Of 64 uses being looked at, the compound has sofar been approved as safe and effective in 7, including use as an antacid, said Sharon Snider, a spokeswoman.

Chemically, sodium bicarbonate is a base that consumes and neutralizes acid. Byproducts of this reaction include water and carbon dioxide gas, which bubbles off and forces burping.

But many experts do not consider sodium bicarbonate the treatment of choice for indigestion, even though it is effective and cheaper than most other antacids, said Dr. Stanley B. Benjamin, chief of the gastroenterology at Georgetown University Medical Center in Washington. "Physicians don't tell people to take baking soda for indigestion, even if it works, because of all the sodium it contains," he said. "Excess sodium causes things like high blood pressure, heart disease and kidney problems."

Dr. Benjamin said stomach ruptures were rare in cases that did not involve anulcer or other abnormality. "The normal stomach is a tough, multi-partitioned organ that hardly ever ruptures," he said. "But like any other sac, like a balloon, it has a bursting point."

Mr. Graves and his lawyers said their search of world medical literature had uncovered about 18 cases of stomach rupture associated with baking soda since the 1920's, including those of at least 6 people who died. But Clifford James, a lawyer representing the company, said the defendants had found only six to eight "unambiguous" associations between stomach rupture and use of sodium bicarbonate. The only death connected with taking baking soda in water occurred in a 1939 case, he said.

"When these rare instances occur, the patient has had some underlying problem with his stomach," he said.

The company said it had never promoted or marketed baking soda as a treatment for indigestion but, because people use sodium bicarbonate for this purpose, had long included instructions on dosage and some warnings, like a warning not to administer the product to small children.

Mr. Minton said an independent study commissioned by the company had concluded that baking soda produced too little carbon dioxide in a short period to be a likely cause, except possibly in rare cases when a stomach was overloaded and not emptying properly, so that the addition of anything else could lead to a rupture.

As a result of the study, the company in late 1983 added a warning to its baking soda boxes that is still in use: "Do not ingest food, liquid or any antacid when stomach is overly full to avoid possible injury to the stomach."

Proprietary to the United Press International 1988

May 18, 1988, Wednesday, AM cycle

SECTION: Regional News

DISTRIBUTION: New York Metro

LENGTH: 687 words

HEADLINE: National Geographic editor sues Arm & Hammer

BYLINE: By J. CRAIG SHEARMAN

DATELINE: TRENTON, N.J.

BODY:

An appeals court Wednesday cleared the way for a National Geographic magazine editor who suffered a stomach rupture to sue the New Jersey company that makes Arm & Hammer baking soda.

A three-judge panel of the Appellate Division of Superior Court reversed the ruling of a trial judge who said a two-year statute of limitations had expired by the time William Graves, of Washington, D.C., sued Church & Dwight Co. of Piscataway.

Graves' suit was filed Aug. 8, 1984, almost five years after the Aug. 22, 1979, incident that allegedly caused his serious stomach problem.

Writing for the panel, Judge Sylvia Pressler said Graves' suit was still permitted because he realized the connection between the baking soda and his illness only 10 months before filing suit, after watching a television news account of a similar incident.

According to the court's 11-page opinion, Graves and his wife, Joyce, were vacationing at their home on Martha's Vineyard, off Cape Cod, Mass., when he awoke after midnight suffering from indigestion.

Graves couldn't find any Alka-Seltzer or Bisodol, two over-the-counter antacids he had used before, so instead prepared a bicarbonate of soda mixture from a small amount of Arm & Hammer baking soda and water.

''Before he could put the glass down, he was overcome by terrible pain and fell to the floor,'' Pressler wrote.

An ambulance took Graves to Martha's Vineyard Hospital, where doctors decided Graves had suffered a peforated stomach ulcer and performed emergency surgery, finding a 2.4-inch tear near where the esophagus joins the stomach.

While a perforated ulcer was the only explanation doctors could find, they noted that no actual ulcer was found and that the tear was about 1 times the length normally associated with an ulcer.

Church & Dwight executives have argued in depositions that baking soda has been safely used as an antacid for 140 years. Court papers indicate only six or seven cases of similar illness have been reported since 1926.

Graves, a senior associate editor at National Geographic, stopped smoking after the incident, reduced his alcohol intake, went on a bland diet and began taking ulcer medicine. In addition, he underwent several hospitalizations over the next four years.

Graves first made a connection between the incident and the baking soda in October 1983 when another editor brought to his attention a television news account of a Virginia man who suffered similar injuries and illness after taking bicarbonate of soda and also sued Church & Dwight. That suit, according to courtpapers, had already been settled under undisclosed terms.

Graves contacted his doctor, who in turn contacted Dr. Edward Moore, a Medical College of Virginia physician who, in the television report, blamed his client's illness on the baking soda.

Moore, according to court papers, said bicarbonate of soda can combine with stomach acids to form carbon dioxide. If the stomach is already stretched by overeating, the rapid release of gases can cause ''an enormous rise in pressure'' that can cause a rupture.

Moore and Graves' doctor, Charles Claydon of Martha's Vineyard Hospital, exchanged medical data that was then relayed to Graves' attorney, resulting in the suit.

Attorneys for Church & Dwight argued before the trial judge that Graves suspected or should have suspected the connection between his illness and their client's product immediately, regardless of whether there actually was any connection. The two-year statute of limitations on such suits had run out almost three years before the suit was filed, they said.

''Even the most average of persons would suspect a cause and effect between the taking of the product and the pain and subsequent surgery,'' the attorneys said.

Pressler disagreed, writing that the cause and effect in such an incident can be difficult to prove and there was no widespread knowledge even within the medical community of bicarbonate of soda causing any illness.

''It was for the physicians to make the connection'' and Graves cannot be prevented from suing for not knowing they were wrong, the judge wrote.

If you go to a law library, you can find the actual decisions of the various appeals. These are in the Atlantic Reporter, Second Edition. There were three appeals:

1.) 541 A.2d 725 (1988)

2.) 558 A.2d 463 (1989)

3.) 631 A.2d 1248 (1993)