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 Vol. 22 No. 5, November 2009
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AAP Grand Rounds 22:49 (2009)
© 2009 American Academy of Pediatrics

GASTROENTEROLOGY/HEPATOLOGY/NUTRITION

Rebound Symptoms After PPI Use: Priming the Pump?

Source: Reimer C, Sondergaard BO, Hilsted L, et al. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology. 2009;137(1):80–87; doi:10.1053/j.gastro.2009.03.058[CrossRef][Medline]

The first 20% of the full text of this article appears below.


PICO

Question: Among healthy adults given proton pump inhibitor therapy for eight weeks, do acid-related withdrawal symptoms develop?

Question type: Intervention

Study design: Randomized, double-blind, placebo-controlled trial

 

Danish investigators conducted a randomized, double-blind, placebo-controlled trial to determine the clinical relevance of rebound acid hypersecretion (RAHS) after proton pump inhibitor (PPI) use. Healthy adult volunteers without acid-related disease or symptoms were randomized to receive either 12 weeks of placebo or 8 weeks of esomeprazole 40 mg once daily followed by 4 weeks of placebo. Subjects completed the Gastrointestinal Symptom Rating Scale (GSRS), a 15-item instrument, weekly. A GSRS score of >2 for any one of three symptoms (dyspepsia, heartburn, or acid regurgitation) was defined as clinically relevant. Plasma levels of gastrin and chromogranin A (CgA) were measured at weeks 4, 8, and 12. Antacid tablets were allowed for bothersome acid-related symptoms during . . . [Full Text of this Article]

Chandran Alexander, MD and Neal S. LeLeiko, MD, PhD, FAAP
Pediatrics, Brown School of Medicine, and Pediatric Gastroenterology, Nutrition and Liver Disease, Hasbro Children’s Hospital, Providence, RI