{"id":139,"date":"2009-07-06T15:34:11","date_gmt":"2009-07-06T19:34:11","guid":{"rendered":"http:\/\/blogs.nejm.org\/gutcheck\/?p=139"},"modified":"2009-07-06T15:34:11","modified_gmt":"2009-07-06T19:34:11","slug":"rebound-acid-symptoms-with-ppi-use-the-real-issue-is-why-are-ppis-used-in-the-first-place","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/rebound-acid-symptoms-with-ppi-use-the-real-issue-is-why-are-ppis-used-in-the-first-place\/2009\/07\/06\/","title":{"rendered":"The real issue in PPI-induced acid rebound: Why are PPIs used in the first place?"},"content":{"rendered":"<p>A great deal of alarm has been voiced over a recent report that some patients with no previous acid-related dyspepsia or GERD developed acid symptoms after stopping PPI therapy in a month-long trial.<\/p>\n<p>Should we really be surprised by this finding? Not really. PPI use is known to cause acid rebound, and the effect is thought to be related to PPI-induced gastrin secretion (secondary to an increase in gastric pH) and to gastrin\u2019s effect on parietal cell mass expansion, which leads to increased acid secretion.<\/p>\n<p>Should we be concerned that these drugs are being given to patients who have no acid-related symptoms? Absolutely. In my opinion, a PPI is warranted only if patient history indicates that gastrointestinal symptoms are likely acid related. These drugs should not be used for every abdominal discomfort or complaint. <\/p>\n<p>The real take-home message from this study is not to stop taking PPIs, but rather to take a history and not to use PPIs (or for that matter any drug) unless we have a clear understanding of what we are trying to diagnose or treat.<\/p>\n<p>What do you think?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A great deal of alarm has been voiced over a recent report that some patients with no previous acid-related dyspepsia or GERD developed acid symptoms after stopping PPI therapy in a month-long trial. Should we really be surprised by this finding? Not really. PPI use is known to cause acid rebound, and the effect is [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-139","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/comments?post=139"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/139\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/media?parent=139"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/categories?post=139"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/tags?post=139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}