{'fraction_non_alphanumeric': 0.05308352849336456, 'fraction_numerical': 0.06557377049180328, 'mean_word_length': 5.253658536585366, 'pattern_counts': {'":': 0, '<': 5, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Rebound hypersecretion after H2‐antagonist withdrawal—a comparative study with nizatidine, ranitidine and famotidine

Our previous study demonstrated rebound nocturnal acid hypersecretion after a 4‐week course of nizatidine. Nocturnal acid output was increased by 77% two days after discontinuing treatment compared with pretreatment values. To confirm this effect with other H2‐blockers we assessed daytime intragastric pH, fasting and meal‐stimulated plasma gastrin and nocturnal acid output in 9 duodenal ulcer patients in remission before, during and two days after treatment with three different drugs. Each patient received 4‐week courses of 300 mg ranitidine, 40 mg famotidine or 300 mg nizatidine, taken at 20.00 hours in randomized order with a ‘washout’period of 4 weeks between each course of drug. Median nocturnal acid output (mmol/10 h) decreased during treatment with ranitidine to 3 (range 0–17), famotidine to 4 (1–12) and nizatidine 6 (0–40) compared with the respective pre‐treatment values, 49 (20–126; P < 0.01), 52 (22–105; P < 0.01) and 32 (23–114; P < 0.01). Two days after discontinuing treatment nocturnal acid output was increased after ranitidine at 77 (28–237; P < 0.04) and after nizatidine at 64 (17–130; P < 0.05) compared with pre‐treatment values.