Health & body · 1990
How quickly can reflux return after stopping long-term omeprazole treatment?
By day 10 after stopping omeprazole, all 14 patients with resistant reflux oesophagitis had symptomatic and endoscopic evidence of recurrence. They had been receiving maintenance treatment for up to 4 years.
Details
To study the effects of abruptly stopping long-term omeprazole maintenance therapy, researchers asked 14 patients with resistant reflux oesophagitis who had received treatment for up to 4 years to stop temporarily. This was a single-group treatment-withdrawal study with measurements over 10 days.
Median basal gastric acid output increased significantly from 0 mmol/h (range, 0–1.18) on day 1 to 1.95 mmol/h (range, 0–8.45) on day 10 (p = 0.01).
Median serum gastrin levels were elevated during omeprazole treatment but fell significantly from 166 to 42 ng/l within the 10-day study (p = 0.01). The median integrated gastrin response after meal stimulation also decreased significantly, from 758.6 ng/l on day 1 to 267.9 ng/l on day 10 (p < 0.001).
On day 10 after omeprazole withdrawal, all 14 patients had both endoscopic and symptomatic evidence of recurrent oesophagitis.
The researchers concluded that, in these reflux patients treated with maintenance omeprazole for up to 4 years, serum gastrin levels normalized promptly and gastric acid production returned within 10 days of stopping treatment. They described a rapid recurrence of worsened reflux symptoms and oesophagitis as a consequence.
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