title: Little necessity of acid inhibition against proton pump inhibitor rebound effects and prior helicobacter pylori eradication therapy in gastric ulcer patients: a randomized prospective study.
abstract: OBJECTIVE
  Helicobacter pylori (H. pylori) eradication therapy increases acid secretion and promotes the development of gastroesophageal reflux disease (GERD) and reflux esophagitis (RE). Rebound acid hypersecretion develops after the use of proton pump inhibitors (PPI). We examined the clinical necessity of acid inhibitors to prevent GERD or RE caused by PPI rebound phenomenon and prior H. pylori eradication therapy.
  
  
  METHODS
  We enrolled 39 patients who underwent successful H. pylori eradication therapy prior to endoscopic mucosal resection of gastric cancer. After 8-week rabeprazole treatment for iatrogenic ulcer, they were randomly divided into two groups (who took nizatidine (group N) and sofalcone (group S)), and took each for 16 weeks, we compared RE/GERD symptoms with the baseline by endoscopy and QUEST score.
  
  
  RESULTS
  All patients had corpus atrophy in which there was no difference between the two groups. Only 1 patient in group S (5.9%) developed symptomatic GERD, and 1 patient in group N (4.5%) developed RE.
  
  
  CONCLUSIONS
  In severe atrophic gastritis patients, there is little clinical necessity of acid inhibitors to prevent GERD/RE caused by PPI rebound and prior H. pylori eradication therapy.
authors.affiliation: Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Wada
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Takata
authors.forename: Shosuke
authors.initials: S
authors.lastname: Kitamura
authors.forename: Akemi
authors.initials: A
authors.lastname: Takamura
authors.forename: Masana
authors.initials: M
authors.lastname: Tatsugami
authors.forename: Shinobu
authors.initials: S
authors.lastname: Imagawa
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D047188:Chalcones / Q000627:therapeutic use*; D015331:Cohort Studies; D004942:Esophagitis, Peptic / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D016481:Helicobacter Infections / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D008875:Middle Aged; D016567:Nizatidine / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D064750:Rabeprazole; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D013276:Stomach Ulcer / Q000188:drug therapy / Q000209:etiology / Q000473:pathology
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D047188:Chalcones; D054328:Proton Pump Inhibitors; C035032:sofalcone; D064750:Rabeprazole; D016567:Nizatidine