According to a new study in the journal Gastroenterology (Gastroenterology 2009 Jul; 137:80), the recurrence of symptoms can be a problem when you stop certain medications used for acid reflux or indigestion. This is known as symptom rebound. Prior studies have shown that when using the medications known as “proton pump inhibitors” (PPIs) to treat reflux, stopping these drugs can cause the acid-making cells in the stomach to go into high gear and make too much stomach acid, thus causing the original symptoms to reappear quickly. Examples of some of the PPIs include Nexium, Prilosec, and Prevacid.

In the above-mentioned study published this month, 120 volunteers who had no history of, or recent symptoms of, acid reflux, were divided into two groups, one group receiving  12 weeks of a placebo, and the other group receiving 8 weeks of a PPI followed by 4 weeks of a placebo. Neither the volunteers nor the researchers knew which group was on which regimen; this is known as a double-blind study. For the first 8 weeks, neither group had much in the way of symptoms. However, after going on a placebo after 8 weeks of treatment with a PPI, this group had significantly more symptoms of heartburn and reflux than did the group that had been on placebo the entire time, showing again that stopping PPIs leads initially to increased stomach acid production.

This is significant for a couple of reasons. One reason is that if you have been placed on a PPI to treat indigestion symptoms, you should expect to have an initial increase in symptoms right after you stop it. This is a temporary thing and should be treated with antacids.

The other reason this is important is that many of us buy over-the-counter (OTC) Prilosec or Prevacid and take it for only a short time or pop it when we think we need it. Then when we stop the medication, the symptoms return and may even seem worse. We then start the PPI again, stopping it when the symptoms are relieved, and on goes the vicious cycle. It is important to know that this does happen with PPIs and that it is temporary. Taking some antacids for a few days should relieve it.

Better yet – don’t take OTC meds, such as PPIs, willy-nilly!  Start with simple things to relieve your reflux symptoms: raise the head of your bed; take off those tight pantyhose; lose some weight; and use antacids first.