I think it just the other day that I said the medical establishment is too busy fighting over whether whether rebound exists to start studying it in a useful way. Time to eat my words.
The July issue of the British Journal of Pharmacology says that researchers succeeded in preventing PPI dependency through a new substance which they call a cholecystokinin CCK2 receptor antagonist. They've only tested it on rats, no human trials yet.
You see, PPIs suppress acid production. However, the body wants stomach acid, so it tries to compensate. Something in the upper stomach called the parietal cell mass gets bigger. Parietal cells produce a hormone called gastrin, which causes those proton pumps to produce hydrochloric acid. This is why rebound occurs. It takes weeks for the parietal cell mass to shrink back down and gastrin levels to return to normal, hence rebound lasts a long time.
Unfortunately, I could only get the abstract. If I have time, I'll take a trip to a library with a journal subscription and get the whole thing. But here's the most exciting thing I've seen so far. They gave rats omeprazole for a while, watched their gastrin levels rise. Then they stopped the omeprazole and gave them this new drug for 3 days. There was no rebound and the gastrin levels returned to normal. Three days. Not two miserable months, three reasonably comfortable days.
The authors also discussed the possibility of using the new drug by itself as a treatment for acid reflux, but I'm most exciting about the chance to reverse rebound without that nasty taper. In fact, there are several companies looking at this drug pathway to treat acid reflux!
Now, rats are not people, and anything could happen between here and the market. We might discover that this just doesn't work in people, or that there are dangerous side effects. Even if it does work, it takes years of human trials to bring a drug to market. Still, it's the most exciting science news I've heard since the Mars lander last week.
Very interesting! Does this mean they are finally acknowledging that rebound does indeed exist?!
The folks who did this study sure acknowledged rebound, it sounds like it was a major thing they were looking for in those poor rats. Now, if only the FDA would add it to product labels, and the American Gastroenterological Association would get on board.
I am not against PPIs. They serve a purpose. I just think they are overprescribed and many doctors ignore or downplay many of the potential problems.
Your bang on with your comments Jane re docs. I think that is true for a number of drugs that are popular. My family doc put me on Prilosec , the specialist on Dexilant and the pharmacist advised me on both , no one mentioned rebound as a possibility.
My family doctor prescribed me Clonazepam some yrs ago as I was in a very high stress job. To his credit he did suggest not to abuse it as it could be habit forming. That was the right thing to do but the stuff I have found on that drug since suggest he should have given me a much stronger warning. I have to say he won't give me repeats though so he does keep an eye on how much I use.
Reality though it is a good thing I look into every drug now myself. I still keep some of the Clonazepam around but is basically for emergencies , some kind of high stress situation such as life delivers now and again.
Reading the issues surrounding withdrawl etc. with that drug it has made some folks lives hellish. It can take 6 months to a year of tapering to get off Clonazepam, issues can range from seizures to acid reflux. Those kind of drugs are just to easily prescribed. In the end they can create a worse situation for those who get used to taking them daily then they are supposed to alleviate.
Docs just don't seem that aware of most of these side effects and the physical and psychological addiction issues for so many drugs they send their patients off with. Good thing for the internet so we can educate ourselves.
as an imbiber of clonazepam for anxiety AND an PPI i hate hate HATE being dependent on these drugs. i know they aren't good for me in the long run.
i am trying so hard to try natural remedies for my stomach. at one point my doctor suggested i take my tecta (or whatever flavor ppi of the month is) twice a day (off label) AND ranatidine 150mg... my goodness i wont have any stomach acid left! i quit the ranatidine after a few days, every morning i would wake up and find myself regurgitating the previous nights supper (tuna subs was really gross btw). i'm just taking the two tectas now and trying to eat better and drink more herbal teas. i still do bad things like have an odd soft drink (never in a bottle i'd keel over in pain) or take an NSAID for a bad headache.
the anxiety .. man, the GERD and ulcers and erosion give me the anxiety, so the klonopin is used.. vicious circle. i really think that the klonopin f's with my stomach too.