Temporary cessation of long-term maintenance treatment with omeprazole in patients with H2-receptor-antagonist-resistant reflux oesophagitis. Effects on symptoms, endoscopy, serum gastrin, and gastric acid output.
To study the effects of sudden withdrawal of long-term maintenance therapy with omeprazole for up to 4 years, 14 patients with resistant reflux oesophagitis were asked to stop their treatment temporarily. Ten days after withdrawal median basal acid output had increased significantly (p = 0.01) from 0 (range, 0-1.18) on day 1 to 1.95 (range, 0-8.45) mmol/h on day 10. Median serum gastrin levels were raised during treatment with omeprazole but decreased significantly from 166 to 42 ng/l within the 10 days of the study (p = 0.01). The median integrated gastrin response after meal stimulation decreased significantly (p less than 0.001) from 758.6 ng/l on day 1 to 267.9 ng/l on day 10. On day 10 after withdrawal of omeprazole all patients had endoscopic and symptomatic evidence of recurrent oesophagitis. Reflux patients receiving maintenance treatment with omeprazole for up to 4 years showed prompt normalization of serum gastrin levels and return of gastric acid production within 10 days after stopping the treatment. Consequently, there was a fast recurrence of aggravation of reflux symptoms and oesophagitis.
Klinkenberg-Knol
E C
EC
Dept. of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands.
Jansen
J B
JB
Lamers
C B
CB
Nelis
F
F
Meuwissen
S G
SG
D000328:Adult; D000368:Aged; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000503:physiopathology; D004945:Esophagoscopy; D005215:Fasting; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005755:Gastrins / Q000097:blood*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D012008:Recurrence; D013997:Time Factors
D005755:Gastrins; D006635:Histamine H2 Antagonists; D009853:Omeprazole