Proton-Pump Inhibitor Withdrawal Rebound Acid Hypersecretion

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Sun, 08/02/2009 - 19:08
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Proton-Pump Inhibitor Withdrawal Rebound Acid Hypersecretion

Reimer C, Søndergaard B, Hilsted L, Bytzer P. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology 2009 Jul;137(1):80-87, 87.e1.

PMID: 1936255
doi:10.1053/j.gastro.2009.03.058    

http://linkinghub.elsevier.com/retrieve/pii/S0016-5085(09)00522-8

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related:
McColl KEL, Gillen D. Evidence That Proton-Pump Inhibitor Therapy Induces the Symptoms it Is Used to Treat. Gastroenterology 2009 Jul;137(1):20-22. (Editorial)

doi:10.1053/j.gastro.2009.05.015    

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Gastroenterology. 2009 Jul;137(1):80-7, 87.e1. Epub 2009 Apr 10.

Comment in:
Gastroenterology. 2009 Jul;137(1):20-2.

Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy.

Reimer C, Søndergaard B, Hilsted L, Bytzer P.
Department of Medical Gastroenterology, Køge University Hospital, Copenhagen University, Copenhagen, Denmark.

BACKGROUND & AIMS: Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). If RAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications. METHODS: A randomized, double-blind, placebo-controlled trial with 120 healthy volunteers was conducted. Participants were randomized to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly. A score of >2 on 1 of the questions regarding heartburn, acid regurgitation, or dyspepsia was defined as a clinically relevant acid-related symptom. RESULTS: There were no significant differences between groups in GSRS scores at baseline. GSRS scores for acid-related symptoms were significantly higher in the PPI group at week 10 (1.4 +/- 1.4 vs 1.2 +/- 0.9; P = .023), week 11 (1.4 +/- 1.4 vs 1.2 +/- 0.9; P = .009), and week 12 (1.3 +/- 1.2 vs 1.0 +/- 0.3; P = .001). Forty-four percent (26/59) of those randomized to PPI reported > or = 1 relevant, acid-related symptom in weeks 9-12 compared with 15% (9/59; P

PMID: 19362552

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