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Achlorhydria - Causes, Symptoms, and Management

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Achlorhydria is a condition in which sufficient hydrochloric acid is not present in the stomach. Read below to learn about its causes, symptoms,and management.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At May 26, 2023
Reviewed AtDecember 7, 2023

Introduction:

Achlorhydria is a medical condition that occurs when the stomach is unable to produce sufficient hydrochloric acid. Hydrochloric acid is a vital component of the digestive process, as it helps to break down food and facilitate the absorption of nutrients.

What Are the Causes of Achlorhydria?

There are many potential causes of achlorhydria, including:

  • Autoimmune Disorders: Autoimmune disorders, such as autoimmune gastritis, can damage the cells in the stomach lining that produce hydrochloric acid, leading to a reduction in acid production.

  • Chronic Inflammation of the Stomach Lining: Chronic inflammation of the stomach lining, also known as chronic atrophic gastritis, can lead to a reduction in the number of cells that produce hydrochloric acid.

  • Genetic Factors: Genetic factors can also play a role in the development of achlorhydria. For example, some individuals may inherit a genetic mutation that affects the production of hydrochloric acid.

  • Medications: Certain medications can interfere with the production of hydrochloric acid in the stomach. Proton pump inhibitors (PPIs), a common treatment for acid reflux, can reduce the amount of acid produced in the stomach over time, leading to achlorhydria.

  • Helicobacter Pylori Infection: Helicobacter pylori is a type of bacteria that can cause inflammation of the stomach lining. Chronic infection with this bacteria can lead to a reduction in the number of cells that produce hydrochloric acid.

  • Gastric Surgery: Certain types of gastric surgery, such as gastric bypass surgery, can reduce the amount of acid produced in the stomach, leading to achlorhydria.

  • Aging: As we age, the production of hydrochloric acid in the stomach naturally declines, which can lead to achlorhydria in some individuals.

What Are the Symptoms of Achlorhydria?

It can cause a range of symptoms. However, some people with achlorhydria may not experience any symptoms at all. Common symptoms of achlorhydria can include:

  • Bloating: Without enough stomach acid to break down food, some people with achlorhydria may experience bloating after meals.

  • Gas: Similarly, the undigested food in the stomach may lead to excess gas production and flatulence.

  • Abdominal Pain: Some people with achlorhydria may experience abdominal pain, particularly after eating.

  • Diarrhea: The lack of stomach acid may also cause diarrhea, as undigested food passes through the digestive system more quickly.

  • Nutritional Deficiencies: Achlorhydria can lead to nutritional deficiencies, particularly in iron, calcium, and vitamin B12. It results in symptoms including fatigue, weakness, and anemia.

  • Weight Loss: In some cases, achlorhydria can lead to unintended weight loss due to the lack of nutrient absorption.

  • Increased Risk of Infections: Without sufficient stomach acid, the body is not able to defend against harmful bacteria and other pathogens. This can increase the risk of infections in the digestive system.

How to Diagnose Achlorhydria?

The following are some common diagnostic tests used to diagnose achlorhydria:

  • Gastric Analysis: This involves inserting a tube through the nose or mouth and into the stomach to measure the acidity of the stomach contents. If the pH (potential of hydrogen) of the stomach contents is higher than normal, it may suggest achlorhydria.

  • Blood Tests: Blood tests can help to identify any nutritional deficiencies that may be associated with achlorhydria, such as low levels of vitamin B12, iron or calcium.

  • Helicobacter Pylori Testing: Testing for the presence of Helicobacter pylori, a bacteria that can cause inflammation of the stomach lining and lead to achlorhydria.

  • Endoscopy: This involves inserting a flexible tube with a camera through the mouth and into the stomach to examine the stomach lining. Biopsies of the stomach lining can also be taken during an endoscopy to look for signs of inflammation or damage to the cells that produce hydrochloric acid.

  • Heidelberg Test: This is a non-invasive test that involves swallowing a capsule containing a radio transmitter. The transmitter measures the pH of the stomach acid as the capsule passes through the digestive system.

What Is the Treatment of Achlorhydria?

The treatment of achlorhydria depends on the underlying cause of the condition. The following are some of the common treatment options:

  • Supplements: Nutritional deficiencies associated with achlorhydria can be treated with supplements of vitamin B12, iron, or calcium.

  • Acid Supplementation: For some individuals with achlorhydria, taking supplemental hydrochloric acid with meals can help to improve digestion and reduce symptoms.

  • Medications: In some cases, medications such as proton pump inhibitors or histamine blockers may be used to help reduce symptoms of acid reflux, although long-term use of these medications may further reduce acid production.

  • Antibiotics: If Helicobacter pylori infection is identified as the underlying cause of achlorhydria, antibiotics may be prescribed to treat the infection and reduce inflammation in the stomach lining.

  • Treatment of Underlying Conditions: Treating underlying conditions such as autoimmune disorders or chronic inflammation of the stomach lining can help to improve acid production and reduce symptoms of achlorhydria.

What Are the Lifestyle Changes Required in Achlorhydria?

There are several lifestyle modifications that may help to prevent or reduce symptoms of achlorhydria:

  • Avoid Trigger Foods: Certain foods trigger various digestive symptoms and acid reflux in individuals. Examples of trigger foods are spicy or acidic foods, caffeine, and alcohol.

  • Eat Smaller, More Frequent Meals: Eating smaller, more frequent meals throughout the day can help to reduce the amount of undigested food in the stomach and improve digestion.

  • Chew Food Thoroughly: Chewing food thoroughly can help to break down food particles and improve digestion.

  • Maintain a Healthy Weight: Being overweight can put pressure on the stomach and increase the risk of acid reflux and other digestive symptoms.

  • Exercise Regularly: Regular exercise can help to improve digestion and reduce the risk of acid reflux and other digestive symptoms.

  • Quit Smoking: Smoking can increase the risk of acid reflux and other digestive symptoms, as well as increase the risk of developing certain digestive conditions.

  • Manage Stress: Stress can increase the risk of acid reflux and other digestive symptoms. People should practice relaxation techniques such as deep breathing, meditation, or yoga. These help in stress management.

What Are the Complications of Achlorhydria?

Achlorhydria can lead to several complications if left untreated, including:

  • Malnutrition: Achlorhydria can lead to malabsorption of important nutrients, such as vitamin B12, iron, and calcium, which can lead to deficiencies and a range of health problems.

  • Increased Risk of Infections: The low acidity of the stomach can increase the risk of bacterial or fungal infections in the digestive tract.

  • Gastrointestinal Disorders: Achlorhydria has been linked to an increased risk of gastrointestinal disorders, such as gastric cancer, atrophic gastritis, and pernicious anemia.

  • Osteoporosis: The decreased absorption of calcium can lead to a loss of bone density and an increased risk of osteoporosis.

  • Iron-Deficiency Anemia: Achlorhydria can lead to a decreased absorption of iron, which can lead to anemia.

Conclusion:

Achlorhydria is a condition that arises due to the absence of hydrochloric acid in the stomach, resulting in digestive symptoms and deficiencies in essential nutrients. A combination of medical history, physical examination, and laboratory tests is required for diagnosis. The treatment plan varies based on the underlying cause of the condition. It is possible to prevent or alleviate the symptoms by adopting certain lifestyle changes. If left untreated, achlorhydria can cause severe health problems such as malnutrition, infections, gastrointestinal disorders, osteoporosis, and anemia. Seeking medical assistance is essential for proper diagnosis and treatment.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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