Rebound hypersecretion after inhibition of gastric acid secretion.
Drugs inhibiting gastric acid secretion are widely used because of the high prevalence of acid-related disorders. However, from clinical experience it seems that symptom relapse is common after withdrawal of these drugs. Experimental as well as clinical studies have demonstrated an increased acid secretion after a period of treatment with either histamine 2 receptor antagonists or proton pump inhibitors. Rebound hypersecretion is likely to reflect the following sequence of events: Long-term inhibition of acid output is accompanied by elevated serum gastrin levels, leading to enterochromaffin-like cell activation and proliferation, resulting in increased amounts of histamine being mobilized from these cells to stimulate the parietal cells. The clinical consequences of rebound hypersecretion have not been settled.
Qvigstad
Gunnar
G
Department of Medicine, Section of Gastroenterology, St. Olavs Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway. gunnarq@medisin.ntnu.no
Waldum
Helge
H
D000818:Animals; D015415:Biomarkers / Q000097:blood; D053379:Chromogranin A; D019861:Enterochromaffin-like Cells / Q000187:drug effects / Q000378:metabolism; D005744:Gastric Acid / Q000378:metabolism*; D005753:Gastric Mucosa / Q000378:metabolism; D005755:Gastrins / Q000097:blood; D005764:Gastroesophageal Reflux / Q000097:blood / Q000188:drug therapy*; D006632:Histamine / Q000096:biosynthesis; D006635:Histamine H2 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D010187:Pancreatic Hormones / Q000097:blood; D010295:Parietal Cells, Gastric / Q000378:metabolism; D054328:Proton Pump Inhibitors; D043887:Receptor, Cholecystokinin B / Q000819:agonists; D012008:Recurrence; D013997:Time Factors
D015415:Biomarkers; D053379:Chromogranin A; D005755:Gastrins; D006635:Histamine H2 Antagonists; D010187:Pancreatic Hormones; D054328:Proton Pump Inhibitors; D043887:Receptor, Cholecystokinin B; C050836:pancreastatin; D006632:Histamine