Abstract
Administration of omeprazole induces increases in serum concentrations of pepsinogens A and C. In 10 patients with reflux esophagitis who were on continuous maintenance treatment, the effect of cessation of omeprazole administration on serum pepsinogens was studied. Pepsinogens A and C were measured in serum samples on days 0, 1, 2, 4, 7, and 9 after treatment and the results were compared with the values available in eight patients at a time before omeprazole treatment. Serum pepsinogen A levels decreased gradually after cessation of omeprazole administration, and all values fell into the normal range after the seventh day of the study period, but were still higher than before therapy. Seven of 10 patients showed a decrease of pepsinogen C after nine days, but two patients had still increased levels at the end of the study period. The pepsinogen A: C ratio on the ninth day after cessation was significantly lower than on day 10 during omeprazole therapy. We conclude that long-term maintenance therapy with omeprazole induces significant increases in both serum pepsinogens. After cessation of omeprazole treatment, serum pepsinogens rapidly decrease in most patients, but continue to be higher before therapy for at least nine days.
Similar content being viewed by others
References
Fellenius E, Berglindh T, Sachs G, Olbe L, Elander B, Sjöstrand S-E, Wallmark B: Substituted benzimidazoles inhibit gastric acid secretion by blocking H+/K+ ATPase. Nature 290:159–161, 1981
Festen HPM, Thijs JC, Lamers CBHW, Jansen JBMJ, Pals G, Frants RR, Défize J, Meuwissen SGM: Effect of oral omeprazole on serum gastrin and serum pepsinogen I levels. Gastroenterology 87:1030–1034, 1984
Crobach LFSJ, Jansen JBMJ, Lamers CBHW: Effect of intermittent weekend therapy with omeprazole on basal and postprandial serum gastrin concentrations in patients with duodenal ulcer. Clin Pharmacol Ther 43:643–647, 1988
Ten Kate RW, Tuynman HARE, Festen HPM, Pals G, Meuwissen SGM: Effect of high dose omeprazole on gastric pepsin secretion and serum pepsinogen levels in man. Eur J Clin Pharmacol 35:173–176, 1988
Biemond I, Crobach LFSJ, Jansen JBMJ, Lamers CBHW: Effect of short-term omeprazole administration on serum pepsinogens in relation to fasting serum gastrin and gastric acid secretion. Eur J Clin Pharmacol 37:345–349, 1989
Biemond I, Crobach LFSJ, Jansen JBMJ, Lamers CBHW: Effect of intermittent administration of omeprazole on serum pepsinogens in duodenal ulcer patients and healthy volunteers. Br J Clin Pharmacol 29:465–472, 1990
Johnson LR: New aspects of the trophic action of gastrointestinal hormones. Gastroenterology 72:788–792, 1977
Ekman L, Hansson E, Havu N, Carlsson E, Lundberg C: Toxicological studies on omeprazole. Scand J Gastroenterol 20(suppl 108):53–69, 1985
Samloff IM, Varis K, Ihamaki T, Siurala M, Rotter JI: Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia. Gastroenterology 83:204–209, 1982
Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen M, Ledin T, Szecsi PB: The ratio of pepsinogen A to pepsinogen C: A sensitive test for atrophic gastritis. Scand J Gastroenterol 24:870–876, 1989
Jansen JBMJ, Klinkenberg-Knol EC, Meuwissen SGM, Bruijne de JW, Festen HPM, Snel P, Luckers AEG, Biemond I, Lamers CBHW: Effects of long-term treatment with omeprazole on serum gatrin and serum group A and C pepsinogens in patients with reflux esophagitis. Gastroenterology 99:621–628, 1990
Biemond I, Jansen JBMJ, Crobach LFSJ, Kreuning J, Lamers CBHW: Radioimmunoassay of human pepsinogen A and pepsinogen C. Eur J Clin Chem Clin Biochem 27:19–25, 1989
Ten Kate RW, Pals G, Donker AJM, Meuwissen SGM: The release of pepsinogen A and C into the circulation by the gastric mucosa in man. Med Sci Res 16:1303–1304, 1988
Lind T, Cederberg C, Ekenved G, Haglund U, Olbe L: Effect of omeprazole—a gastric proton pump inhibitor-on pentagastrin stimulated acid secretion in man. Gut 24:270–276, 1983
Sharma BK, Walt RP, Pounder RE, Gomes M de FA, Wood EC, Logan LH: Optimal dose of oral omeprazole for maximal 24 hour decrease of intragastric acidity. Gut 25:957–964, 1984
Sharma B, Axelson M, Pounder R, Lundborg P, Öhman M, Santana A, Talbot M, Cederberg C: Acid secretory capacity and plasma gastrin concentration after administration of omeprazole to normal subjects. Aliment Pharmacol Ther 1:67–76, 1987
Sloas DD, Hirschowitz BI, Chey WY: A nongastrin malignant ampullary tumor causing gastric acid and pepsin hypersecretion. J Clin Gastroenterol 12:573–578, 1990
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Biemond, I., Klinkenberg-Knol, E.C., Lamers, C.B.H.W. et al. Serum pepsinogens after interruption of long-term maintenance therapy with omeprazole in patients with reflux esophagitis. Digest Dis Sci 38, 932–936 (1993). https://doi.org/10.1007/BF01295923
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01295923