A patient stops taking a proton pump inhibitor (PPI) after 6 weeks of therapy for treatment of peptic ulcer disease. The patient reports symptoms of dyspepsia to the nurse. The nurse will tell this patient to:
a. come to the clinic to be tested for Clostridium difficile.
b. resume taking the PPI, because long-term therapy is necessary.
c. resume taking the PPI until symptoms resolve completely.
d. try an antacid to see whether it relieves these symptoms.
ANS: D
When patients stop taking a PPI, a rebound hypersecretion of gastric acid can cause dyspepsia. This can be managed with an antacid. Although C. difficile infection is associated with dose-related increases in PPIs, the symptoms include diarrhea, not dyspepsia, so testing is not indicated for this patient. Resuming the PPI is not indicated, because these symptoms can be managed with antacids.
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