Serum pepsinogens after interruption of long-term maintenance therapy with omeprazole in patients with reflux esophagitis.

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 0 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.