Hoshikawa Y, Nikaki K, Sonmez S, et al. - In this investigation involving 37 individuals, researchers assessed the impact of stopping long-term proton pump inhibitors (PPIs) on patients with heartburn and its correlation with esophageal acid exposure. Heartburn patients on long-term PPIs had symptom questionnaire, high-resolution manometry, and 24h ambulatory impedance-pH studies, following a 7-day PPIs discontinuation. The link was explored between exacerbation of symptoms and findings on ambulatory reflux studies. Twenty-seven patients had exacerbation of heartburn after stopping PPIs. It does not appear that heartburn exacerbation after discontinuation of PPIs is due to increased exposure to esophageal acid.