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In a recent randomized trial, asymptomatic volunteers developed dyspeptic symptoms after receiving an 8-week course of esomeprazole (JW Gen Med Jul 14 2009). Now, Swedish researchers have examined this phenomenon of rebound dyspepsia after withdrawal of proton-pump inhibitors (PPIs).
Forty-eight asymptomatic Helicobacter pylori–negative volunteers were randomized to receive daily pantoprazole (40 mg) or placebo for 4 weeks and then were followed for an additional 6 weeks. One week after treatment was completed, pantoprazole recipients were significantly more likely to report dyspeptic symptoms than were placebo recipients (44% vs. 9%), and mean scores on a 12-point dyspepsia symptom scale were significantly higher among pantoprazole recipien…