Achlorhydria: Causes, Symptoms and Treatment

Achlorhydria

The stomach secretes gastric juices that aid with digestion. This gastric juice is composed of sodium chloride, potassium chloride and hydrochloric acid.

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Hydrochloric acid due to its acidic nature protects our bodies against pathogens ingested with food and water. It also plays a crucial part in the digestion of food.

The parietal cells lining the stomach are mainly responsible for its production. However, circumstances may cause the production of the acid to be reduced or even absent; a condition called Achlorhydria. 

Achlorhydria, also known as hypochlorhydria, occurs when there is an absence of hydrochloric acid in the stomach. The condition is usually an indicator for an underlying illness and can impair the process of digestion and lead to overall damage of the digestive system.

Without the acid, the body would not be able to digest protein and becomes more susceptible to gastrointestinal infections. If left untreated, achlorhydria can be fatal. 

Causes and Risk Factors of Achlorhydria

  • Hypothyroidism: This can significantly slow down the body’s metabolism, resulting in a decrease in the production of gastric acid
  • Surgery: Surgeries aimed at losing weight like the gastric bypass procedure can reduce the size of the stomach and alter how the body processes food. When the function of a significant portion of the stomach is altered, it can result in the decreased production of stomach acid.
  • Medications: Medicines like antacid are a necessary solution to indigestion and heartburn; and Proton pump inhibitors (PPIs) which help to alleviate symptoms from gastroesophageal reflux disease (GERD). These medications can reduce acidity in the stomach. 
  • Helicobacter. pylori infection: This is an infection that causes peptic ulcers. The infection can reduce the amount of stomach acid produced if left untreated. 
  • Radiation to stomach: Radiation to the stomach has also been reported to cause achlorhydria.
  • Autoimmune disorders: Certain autoimmune diseases such as Pernicious anemia can affect stomach acid production. Pernicious anemia occurs when the autoantibodies cause the destruction of the parietal cells that produce stomach acid.

Signs and Symptoms of Achlorhydria

Achlorhydria can increase one’s risk of developing iron deficiency anemia. This is because, without stomach acids, the body will have difficulties absorbing iron.

If diagnosed with achlorhydria, doctors often check for anemia. Other achlorhydria symptoms can include:

Bacterial overgrowth of the small intestine can occur in the absence of stomach acid. Complications can also result in malabsorption, a condition where the stomach cannot absorb nutrients from food.

Diagnosis

If achlorhydria is suspected, doctors will take note of the patient’s medical history and current symptoms. They may choose to test the pH levels stomach if you have a history of exhibiting the following symptoms to confirm the diagnosis:

  • Increased bowel movements
  • Signs of malnutrition
  • Acid reflux
  • Digestive issues
  • Weight loss
  • Abdominal pain and bloating

Gastric juices should typically have a pH of around 1.5, which is very acidic. Other tests that can be conducted include:

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  • Antiparietal and anti-intrinsic factor antibody
  • Serum gastrin levels (high serum gastrin levels greater than 500 to 1000 pg/mL may indicate achlorhydria)
  • Gastric pH monitoring
  • Hemoglobin level
  • Biopsy of stomach
  • Serum pepsinogen level (a low serum pepsinogen level indicates achlorhydria)
  • Tests for H. pylori infection 

Treatment 

There is no specific treatment for achlorhydria. Treating the condition depends on the cause. For achlorhydria caused by H. pylori infection, doctors may prescribe antibiotics to treat the infection.

If the patient has been prescribed a PPI medication to alleviate acid reflux symptoms, the doctor may switch the prescription to avoid triggering achlorhydria.

Achlorhydria has life-threatening consequences and can lead to significant health problems and complications. It is necessary for the disorder to be treated as soon as possible. 

Victor Anunobi
Victor Anunobi is an environmentalist, writer and movie enthusiast living in the city of Lagos, Nigeria. He enjoys long walks, food and alternative music.