PPIs May Induce Reflux Symptoms & Become Addictive

According to a new study, published in the Journal of Gastroenterology, proton pump inhibitors (PPIs) can become addictive, and may even induce the symptoms that they were designed to treat.

Christina Reimer, MD of Copenhagen University and lead author of the study, stated, "The observation that more than 40 percent of healthy volunteers, who have never been bothered by heartburn, acid regurgitation or dyspepsia, develop such symptoms in the weeks after cessation of PPIs is remarkable and has potentially important clinical and economic implications. This study indicates unrecognized aspects of PPI withdrawal and is a very strong indication of a clinically significant acid rebound phenomenon that needs to be investigated in proper patient populations."

According to the study, taking PPIs for just eight weeks can result in a dependency on the drug. And when the patients stop taking the PPIs, symptoms of heartburn, regurgitation, and dyspepsia occurred in forty percent of patients with no previous symptoms.

In a randomized double-blind placebo-controlled trial, researchers wanted to determine if long-term treatment with a PPI creates a need for continuous treatment. 120 healthy participants were randomized to 12 weeks of placebo or eight weeks of esomeprazole (40 mg per day) followed by four weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly.

Symptoms of stomach upset occurred within two weeks after acid reducing drugs were discontinued in the majority of patients studied.

Dr Reimer stated, "We find it highly likely that the symptoms observed in this trial are caused by rebound acid hypersecretion and that this phenomenon is equally relevant in patients treated long term with PPIs. If rebound acid hypersecretion induces acid-related symptoms, this might lead to PPI dependency."

Proton pump inhibitors have gotten some bad press lately:

• PPIs may increase the risk of fractures
• PPIs associated with increased risk of hospital-acquired pneumonia
• PPIs & Plavix together may increase risk of heart attack
• GERD patients taking PPIs may experience recurring symptoms