Achlorhydria: Difference between revisions

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{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = Achlorhydria|
   Image          = Hydrogen-chloride-3D-vdW-labelled.png |
   Image          = Hydrogen-chloride-3D-vdW-labelled.png |
   Caption        = [[Hydrogen chloride]] (major component of [[gastric acid]]) |
   Caption        = [[Hydrogen chloride]] (major component of [[gastric acid]]) |
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{{Achlorhydria}}
{{Achlorhydria}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{CMG}}
{{CMG}}


'''For patient information click [[{{PAGENAME}} (patient information)|here]]'
==[[Achlorhydria overview|Overview]]==
 
==[[Achlorhydria historical perspective|Historical Perspective]]==
 
==[[Achlorhydria pathophysiology|Pathophysiology]]==
 
==[[Achlorhydria causes|Causes]]==


==Overview==
==[[Achlorhydria differential diagnosis|Differentiating Achlorhydria from other Diseases]]==


'''Achlorhydria''' and '''[[hypochlorhydria]]''' refer to states where the production of [[gastric acid]] in the [[stomach]] is absent or low, respectively. It is associated with various other medical problems.
==[[Achlorhydria epidemiology and demographics|Epidemiology and Demographics]]==


==Signs and symptoms==
==[[Achlorhydria risk factors|Risk Factors]]==
The decreased acid level itself causes few symptoms, but low acid levels in the stomach are linked with [[Small bowel bacterial overgrowth syndrome|bacterial overgrowth]] (as the stomach does not kill microbes normally present in food), which can manifest as [[diarrhoea]] or [[malabsorption|decreased absorption]] of nutrients or vitamins. Risk of particular infections, such as ''[[Vibrio vulnificus]]'' (commonly from seafood) is increased.


==Causes==
==[[Achlorhydria natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* [[Autoimmune disorder]]s where there is [[antibody]] production against [[parietal cell]]s which normally produce gastric acid.
* The use of [[antacids]] or drugs that decrease gastric acid production (such as [[H2-receptor antagonist]]s) or transport (such as [[proton pump inhibitor]]s).
* A symptom of [[rare disease]]s such as [[mucolipidosis]] (type IV).
* A symptom of ''[[Helicobacter pylori]]'' infection which neutralizes and decreases secretion of [[gastric acid]] to aid its survival in the stomach.<ref name="pmid9207257">{{cite journal |author=El-Omar EM, Oien K, El-Nujumi A, ''et al'' |title=Helicobacter pylori infection and chronic gastric acid hyposecretion |journal=Gastroenterology |volume=113 |issue=1 |pages=15–24 |year=1997 |pmid=9207257 |doi=}}</ref>
* A symptom of [[pernicious anemia]], [[atrophic gastritis]], [[VIPoma]]s or of [[stomach cancer]].
* [[Radiation therapy]] involving the stomach.


==Diagnosis==
==Diagnosis==
90% of all patients with achlorhydria have detectable antibodies against the [[H+/K+ ATP-ase]] proton pump. The diagnosis is made if the gastric pH remains high (>4.0) despite maximum [[pentagastrin]] stimulation. High [[gastrin]] levels are often detected.
[[Achlorhydria history and symptoms| History and Symptoms]] | [[Achlorhydria physical examination | Physical Examination]] | [[Achlorhydria laboratory findings|Laboratory Findings]] | [[Achlorhydria chest x ray|Chest X Ray]] | [[Achlorhydria CT|CT]] | [[Achlorhydria MRI|MRI]] | [[Achlorhydria ultrasound|Ultrasound]] | [[Achlorhydria other imaging findings|Other Imaging Findings]] | [[Achlorhydria other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
Treatment focuses on addressing the underlying cause, supplementation of [[vitamin]]s like [[vitamin B12]] (which is poorly absorbed in the absence of [[intrinsic factor]]) in [[autoimmune disorders]], and avoiding foods that may have a high [[microbial]] load, and in some cases the use of Betaine hydrochloride has been successful. Usually little or no treatment is necessary. [[Antibiotic]]s may be needed in significant bacterial overgrowth.
[[Achlorhydria medical therapy|Medical Therapy]] | [[Achlorhydria primary prevention|Primary Prevention]] | [[Achlorhydria secondary prevention|Secondary Prevention]] | [[Achlorhydria cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Achlorhydria future or investigational therapies|Future or Investigational Therapies]]


==Prognosis==
==Case Studies==
Little is known on the prognosis of achlorhydria, although there have been reports of an increased risk of gastric cancer.<ref name="pmid3952447">{{cite journal |author=Svendsen JH, Dahl C, Svendsen LB, Christiansen PM |title=Gastric cancer risk in achlorhydric patients. A long-term follow-up study |journal=Scand. J. Gastroenterol. |volume=21 |issue=1 |pages=16–20 |year=1986 |pmid=3952447 |doi=}}</ref>
[[Achlorhydria case study one|Case#1]]


==References==
==Related Chapters==
<references/>
 
==See also==
*[[Hyperchlorhydria]]
*[[Hyperchlorhydria]]
*[[Isopropamide]]
*[[Isopropamide]]
*[[Fundic gland polyposis]]
*[[Fundic gland polyposis]]


{{Gastroenterology}}
{{Gastroenterology}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Disease]]


[[de:Achlorhydrie]]
[[de:Achlorhydrie]]

Revision as of 13:41, 4 September 2012

Achlorhydria
Hydrogen chloride (major component of gastric acid)
ICD-10 K31.8
ICD-9 536.0
DiseasesDB 29513
MeSH D000126

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Achlorhydria from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case#1

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