Rebound increased acid secretion has been observed after discontinuing omeprazole treatment in Helicobacter pylori-negative, but not H. pylori-positive, subjects.
In this study, researchers from Scotland evaluated 12 H. pylori-negative and 20 H. pylori-positive subjects.
|H. pylori-uneradicated subjects had no rebound increased secretion.|
Each participant underwent a basal, submaximal, and maximal pentagastrin-stimulated acid secretion study before, during, and after a 56-day course of omeprazole.
Ten of the H. pylori-positive subjects had their infection eradicated during the last week of treatment.
The team found that in the H. pylori-negative subjects, there was rebound secretion of submaximal and maximal acid output. This persisted until at least 56 days after discontinuing omeprazole.
The H. pylori-uneradicated subjects had no rebound increased secretion other than in maximal acid output at 28 and at 42 days after treatment.
The researchers determined that in the subjects who had their H. pylori eradicated close to the end of omeprazole, there was rebound increased secretion of submaximal acid output. This lasted at least 56 days and maximal acid output lasted 28 days after treatment.
Dr Derek Gillen and colleagues concluded, "Rebound increased acid secretion following omeprazole is a prolonged phenomenon in H. pylori-negative subjects".
"There is little evidence of it in H. pylori-infected subjects, but eradicating the infection releases the phenomenon".
"The accentuated H. pylori-related oxyntic gastritis induced by omeprazole is likely to protect against the rebound phenomenon.