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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
__NOTOC__
 
{{CMG}}
 
 
 
==Overview==
{{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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   OMIM          = |
   OMIM          = |
   MedlinePlus    = |
   MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
   MeshID        = D000126 |
   MeshID        = D000126 |
}}
}}
{{Search infobox}}
{{Achlorhydria}}
'''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.


==Signs and symptoms==
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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==
{{CMG}}
* [[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).
{{SK}}  Gastric acidity reduced
* 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>
==[[Achlorhydria overview|Overview]]==
* A symptom of [[pernicious anemia]], [[atrophic gastritis]], [[VIPoma]]s or of [[stomach cancer]].
 
* [[Radiation therapy]] involving the stomach.
==[[Achlorhydria historical perspective|Historical Perspective]]==
 
==[[Achlorhydria classification|Classification]]==
 
==[[Achlorhydria pathophysiology|Pathophysiology]]==
 
==[[Achlorhydria causes|Causes]]==
 
==[[Achlorhydria differential diagnosis|Differentiating Achlorhydria from Other Diseases]]==
 
==[[Achlorhydria epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Achlorhydria risk factors|Risk Factors]]==
 
==[[Achlorhydria screening|Screening]]==
 
==[[Achlorhydria natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==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 x ray|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 surgery|Surgery]] | [[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]]

Latest revision as of 20:09, 6 July 2016

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

Achlorhydria Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Achlorhydria from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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

Synonyms and keywords: Gastric acidity reduced

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Achlorhydria from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

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

Treatment

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

Case Studies

Case#1

Related Chapters

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