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Previous research suggests that stopping treatment with proton-pump inhibitors (PPIs) causes rebound hypersecretion of acid. The presumed mechanism is a PPI-induced increase in serum gastrin, which exerts trophic effects on acid-producing gastric cells. When a PPI is withdrawn, these cells are poised to hypersecrete acid. To examine the clinical implications of this phenomenon, Danish researchers conducted a double-blind randomized trial that involved 120 healthy volunteers with no substantial histories of heartburn or dyspepsia; participants received either 12 weeks of placebo or 8 weeks of esomeprazole (40 mg daily) followed by 4 weeks of placebo.
For the initial 8 weeks, mean symptom scores were similar in the esomeprazole and placebo gro…