Achlorhydria is a condition where the stomach does not produce stomach acid, often caused by bacterial infection, pernicious anemia, or other risk factors. It can lead to malnutrition, infection, and gastric cancer. Treatment depends on the underlying cause.
Achlorhydria is a condition in which the stomach does not produce stomach acid. Often, this has an underlying cause such as a bacterial infection or pernicious anemia or the presence of risk factors such as diabetes, thyroid disease or chronic stomach ulcers. People with this condition are at increased risk of malnutrition, infection and gastric cancer.
Stomach acid is produced by the parietal cells, which secrete acid into the stomach. There are several diseases that can disrupt the process of stomach acid production. Additionally, some medications can disrupt this process, including proton pump inhibitors, which are used to treat stomach ulcers, gastroesophageal reflux disease, and similar digestive disorders.
Some types of gastric surgery also stop the production or secretion of stomach acid. One is a gastric bypass procedure called Roux-en-Y, in which the stomach is bypassed, creating a small pouch through which food is shunted. Another is called antrectomy. In this procedure, acid secretion is purposely blocked by removing a portion of the stomach. Antrectomy is a treatment for some types of cancer and digestive disorders.
Helicobacter pylori infection can disrupt stomach acid production and cause achlorhydria. This bacterial species causes stomach ulcers and produces substances that interfere with stomach acid secretion to promote its survival. Some medical conditions also cause achlorhydria. One of them is pernicious anemia, caused by vitamin B12 deficiency. A rare genetically inherited disorder called mucolipidosis type IV can disrupt stomach acid production due to abnormally high levels of fat or carbohydrate accumulation in the parietal cells.
One of the most common symptoms of gastric achlorhydria is malnutrition, which is caused by an impaired ability to absorb vitamins and minerals. The stomach also has a reduced ability to digest protein. Impaired digestion typically causes stomach pain, as the stomach is trying to digest food without the help of stomach acid. Symptoms similar to those of gastroesophageal reflux disease are common; these include heartburn, nausea, difficulty swallowing, and regurgitation of food.
Treatment of achlorhydria depends on the underlying disease that stops the production or secretion of stomach acid. In the case of chronic stomach ulcers caused by Helicobacter pylori infection, for example, the main goal is to treat the infection with antibiotics. Pernicious anemia can be treated with vitamin B12 supplements. Patients are also screened for other vitamin deficiencies that may need to be corrected. When the cause is long-term treatment with proton pump inhibitors, the dose may be reduced to try to correct the acid stomach problem.
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