PMID- 21723045
OWN - NLM
STAT- MEDLINE
DCOM- 20111221
LR  - 20181201
IS  - 1532-2777 (Electronic)
IS  - 0306-9877 (Linking)
VI  - 77
IP  - 3
DP  - 2011 Sep
TI  - Gradual cessation of proton pump inhibitor (PPI) treatment may prevent rebound 
      acid secretion, measured by the alkaline tide method, in dyspepsia and reflux 
      patients.
PG  - 451-2
LID - 10.1016/j.mehy.2011.06.007 [doi]
AB  - Gastro esophageal reflux disease and ulcer related or non-ulcer dyspepsia, 
      attacks 20% of the Western population. These millions of patients are treated 
      continuously with PPI for different periods, many for many years. Recently, 
      rebound acid hypersecretion was recognized as a major clinical event after 
      cessation of PPI therapy. Sustained hypergastrinemia due to daily PPI therapy 
      causes increased acid-secretory capacity that appears when the drug is stopped. 
      The transient increase in blood and urinary pH following gastric secretion has 
      been termed the alkaline tide phenomenon. Carbonic acid, formed in the presence 
      of the enzyme carbonic anhydrase, neutralizes intracellular hydroxyl ions 
      produced as a result of luminal acid secretion. The bicarbonate generated is 
      removed from the cell via the baso-lateral chloride bicarbonate exchanger. We 
      have shown in several studies that this phenomenon parallels acid secretion. 
      Thus, stimulation of acid secretion with test meal increased base excess 
      maximally after 45 min and these changes parallel peak acid output measured in 
      gastric aspirate. We hypothesize that gradual step down cessation of PPI will 
      prevent this clinical relevant event. By measuring alkaline tide after PPI 
      cessation we may prove this hypothesis.
CI  - Copyright (c) 2011 Elsevier Ltd. All rights reserved.
FAU - Niv, Yaron
AU  - Niv Y
AD  - Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, 39 
      Jabotinski Street, Petach Tikva 49100, Israel. yniv@clalit.org.il
LA  - eng
PT  - Journal Article
DEP - 20110701
PL  - United States
TA  - Med Hypotheses
JT  - Medical hypotheses
JID - 7505668
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Drug Administration Schedule
MH  - Dyspepsia/complications/*drug therapy
MH  - Gastric Acid/*metabolism
MH  - Gastroesophageal Reflux/complications/*drug therapy/*prevention & control
MH  - Humans
MH  - Proton Pump Inhibitors/*administration & dosage/pharmacology/therapeutic use
MH  - Secondary Prevention
MH  - Secretory Rate/drug effects
EDAT- 2011/07/05 06:00
MHDA- 2011/12/22 06:00
CRDT- 2011/07/05 06:00
PHST- 2011/03/16 00:00 [received]
PHST- 2011/06/07 00:00 [accepted]
PHST- 2011/07/05 06:00 [entrez]
PHST- 2011/07/05 06:00 [pubmed]
PHST- 2011/12/22 06:00 [medline]
AID - S0306-9877(11)00265-9 [pii]
AID - 10.1016/j.mehy.2011.06.007 [doi]
PST - ppublish
SO  - Med Hypotheses. 2011 Sep;77(3):451-2. doi: 10.1016/j.mehy.2011.06.007. Epub 2011 
      Jul 1.