Related Experiment Video
Updated: May 27, 2026
09:51
Recording Synaptic Plasticity in Acute Hippocampal Slices Maintained in a Small-volume Recycling-, Perfusion-, and Submersion-type Chamber System
Published on: January 1, 2018
Acid inhibition and the acid rebound effect
Ivan Lerotić1, Neven Baršić, Sanja Stojsavljević
1Department of Gastroenterology and Hepatology, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Digestive Diseases (Basel, Switzerland)
|November 19, 2011
Summary
Discontinuation of proton-pump inhibitors (PPIs) can cause rebound acid hypersecretion (RAH), leading to acid-related symptoms. RAH after H2 antagonist therapy is less severe and shorter in duration compared to PPIs.
Area of Science:
- Gastroenterology
- Pharmacology
- Cell Biology
Background:
- Gastric acid secretion is regulated by complex interactions, with gastrin and histamine playing key roles.
- Antisecretory therapies, including H2 antagonists and proton-pump inhibitors (PPIs), can lead to hypergastrinemia and increased enterochromaffin-like (ECL) cell mass.
- Withdrawal of these therapies can result in rebound acid hypersecretion (RAH).
Purpose of the Study:
- To compare the magnitude and duration of rebound acid hypersecretion (RAH) after withdrawal of H2 antagonists versus PPIs.
- To assess the clinical significance and potential for causing symptoms associated with RAH following PPI therapy.
Main Methods:
- Review and synthesis of existing studies quantifying acid hypersecretion after H2 antagonist and PPI cessation.
- Analysis of findings from randomized placebo-controlled studies confirming PPI-induced RAH and associated symptoms.
Main Results:
- RAH following H2 antagonist therapy is generally of low magnitude, short duration, and questionable clinical significance.
- RAH after PPI therapy is more pronounced, lasts longer, and has been confirmed to cause acid-related symptoms in recent studies.
- Increasing PPI use suggests RAH may become a significant factor in treatment withdrawal failure for some patients.
Conclusions:
- Rebound acid hypersecretion is a notable consequence of PPI withdrawal, potentially causing symptoms and complicating therapy cessation.
- The clinical impact of RAH differs significantly between H2 antagonists and PPIs, with PPIs posing a greater concern.
- Understanding and managing RAH is crucial, especially with the widespread use of PPIs for acid-related disorders.
More Related Videos
Related Concept Videos
01:31Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids
In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.
However, this neutralization reaction between...
However, this neutralization reaction between...
01:20Desensitization and Tachyphylaxis
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Several...
01:29Leveling Effect
In acid-base chemistry, the leveling effect refers to the limitation imposed by the solvent on the strength of acids and bases in solution. When a base stronger than the solvent's conjugate base is used, it deprotonates the solvent until the base is entirely consumed, making it ineffective against weaker acids. Conversely, an acid stronger than the solvent's conjugate acid protonates the solvent until the acid is depleted, rendering it ineffective against weaker bases. Essentially, the solvent...
02:19Buffer Effectiveness
Buffer solutions do not have an unlimited capacity to keep the pH relatively constant . Instead, the ability of a buffer solution to resist changes in pH relies on the presence of appreciable amounts of its conjugate weak acid-base pair. When enough strong acid or base is added to substantially lower the concentration of either member of the buffer pair, the buffering action within the solution is compromised.
The buffer capacity is the amount of acid or base that can be added to a given volume...
The buffer capacity is the amount of acid or base that can be added to a given volume...
02:56Buffers
A solution containing appreciable amounts of a weak conjugate acid-base pair is called a buffer solution, or a buffer. Buffer solutions resist a change in pH when small amounts of a strong acid or a strong base are added. A solution of acetic acid and sodium acetate is an example of a buffer that consists of a weak acid and its salt: CH3COOH (aq) + CH3COONa (aq). An example of a buffer that consists of a weak base and its salt is a solution of ammonia and ammonium chloride: NH3 (aq) + NH4Cl...
01:18Indirect-Acting Cholinergic Agonists: Mechanism of Action
Indirect-acting cholinergic agonists work by interacting with an enzyme called acetylcholinesterase (AChE) in the synaptic cleft. They can be reversible or irreversible inhibitors and have different effects on the enzyme.
Reversible inhibitors like edrophonium bind to a specific part of the enzyme called the anionic catalytic site. They form noncovalent bonds, which means they are not strongly attached to the enzyme. This creates a temporary and less stable enzyme–inhibitor complex, leading to...
Reversible inhibitors like edrophonium bind to a specific part of the enzyme called the anionic catalytic site. They form noncovalent bonds, which means they are not strongly attached to the enzyme. This creates a temporary and less stable enzyme–inhibitor complex, leading to...