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Heartburn Drugs May Contribute to the Problem
Date:7/7/2009

take PPIs renew their prescriptions without one of these indications. And the editorial stated that the drugs are being prescribed without hard evidence that acid is involved with the problem. PPIs work by reducing acid production.

For this study, 120 healthy people were randomly assigned to receive 12 weeks of a placebo or eight weeks of Nexium (esomeprazole, 40 milligrams a day), followed by four weeks of placebo.

Forty-four percent of individuals receiving the PPI reported acid-related symptoms afterstopping the medication, compared with 15 percent in the placebo group.

The study authors speculated that the post-treatment effect comes from an acid "rebound" after the period of inhibition. If this does turn out to be the case, the process could end up causing dependency on PPIs, the researchers said.

"Patients need to be informed about the potential effects of the rebound acid hypersecretion and the symptoms it can cause when therapy is initiated," said Reimer, adding that more research into the phenomenon is needed.

"If both patients and their physicians are aware of this temporary period of time after discontinuation [that might include] aggravation or induction of acid-related symptoms, it is possible that withdrawal of therapy is easier to achieve," she added.

Blair Hains, a spokesman for AstraZeneca, which makes Nexium, said: "This study was conducted with healthy volunteers, and the authors acknowledge that they can't be sure that the conclusion can be carried over to patients who have started PPI therapy because of dyspeptic symptoms. A previous systematic review of rebound acid hypersecretion after discontinuation of PPIs concludes that there is no strong evidence for a clinically relevant increased acid production after withdrawal of PPI therapy."

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