Charlie states that he has been using calcium carbonate 5 or 6 times a day. What might this indicate?

Using calcium carbonate 5 or 6 times a day typically suggests that Charlie may be experiencing persistent or worsening heartburn. Calcium carbonate is an antacid commonly used to neutralize stomach acid and relieve heartburn and indigestion. If Charlie needs to take it so frequently, it can indicate that his symptoms are not well controlled, potentially signaling that the underlying issue, such as gastroesophageal reflux disease (GERD), is not being effectively managed.

Moreover, frequent use of antacids can lead to complications or side effects, such as a rebound increase in acidity when the antacid effect wears off. While it's possible that he may not be taking enough calcium carbonate if he is experiencing significant symptoms, the frequency of use is more indicative of a need for better management of his condition rather than an insufficient dosage of the antacid itself.

Therefore, this pattern of usage is likely a reflection of worsening heartburn, as patients often increase the frequency of antacid use when experiencing more severe discomfort, making it a key indicator of his condition.