title: Systematic review: symptoms of rebound acid hypersecretion following proton pump inhibitor treatment.
abstract: BACKGROUND
  While the physiological existence of rebound acid hypersecretion (RAHS) after withdrawal of proton pump inhibitors (PPI) therapy is established, the clinical implications are less certain. It has been speculated that a clinical relevant rebound phenomenon may be responsible for difficulties in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI treatment.
  
  
  METHODS
  PubMed was searched using the terms "rebound acid hypersecretion" and generic names of PPIs.
  
  
  RESULTS
  Five studies were included. Two studies on asymptomatic volunteers found that 44% experienced acid-related symptoms up to 4 weeks after treatment was withdrawn. Symptoms were generally mild to moderate and mainly heartburn and regurgitation. Three studies, using patients with reflux disease, found no signs of symptoms caused by acid rebound.
  
  
  CONCLUSIONS
  Gastric acid rebound hypersecretion following PPI therapy induces reflux-like symptoms post-treatment in asymptomatic volunteers, but the significance of this in patient populations is not clear. The studies in patients with reflux disease found no evidence of symptomatic RAHS, but these studies were hampered by severe methodological weaknesses.
authors: Department of Medicine, Køge Hospital, Copenhagen University, Køge, Denmark. loedrup.ab@gmail.com
authors: Anders Bergh
authors: AB
authors: Lødrup
authors: Christina
authors: C
authors: Reimer
authors: Peter
authors: P
authors: Bytzer
mesh_terms: D058070:Asymptomatic Diseases; D005744:Gastric Acid / Q000378:metabolism*; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012008:Recurrence
chemical_list: D054328:Proton Pump Inhibitors