Summary: A lack of HYDROCHLORIC ACID in GASTRIC JUICE despite stimulation of gastric secretion.

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  1. Friis Hansen L. Achlorhydria is associated with gastric microbial overgrowth and development of cancer: lessons learned from the gastrin knockout mouse. Scand J Clin Lab Invest. 2006;66:607-21 pubmed
    ..The gastrin knockout mice are achlorhydric due to inactivation of the ECL and parietal cells. Moreover, this achlorhydria is associated with intestinal metaplasia and bacterial overgrowth, which ultimately leads to the development of ..
  2. Spicer Z, Miller M, Andringa A, Riddle T, Duffy J, Doetschman T, et al. Stomachs of mice lacking the gastric H,K-ATPase alpha -subunit have achlorhydria, abnormal parietal cells, and ciliated metaplasia. J Biol Chem. 2000;275:21555-65 pubmed
    ..We conclude that ablation of the H,K-ATPase alpha-subunit causes achlorhydria and hypergastrinemia, severe perturbations in the secretory membranes of the parietal cell, and metaplasia of ..
  3. Cunningham R, Dale B, Undy B, Gaunt N. Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea. J Hosp Infect. 2003;54:243-5 pubmed
    ..difficile diarrhoea (odds ratio 2.5, 95% CI 1.5-4.2). Reduction of unnecessary PPI use may be an additional strategy to reduce the incidence of this infection. ..
  4. Rieder G, Merchant J, Haas R. Helicobacter pylori cag-type IV secretion system facilitates corpus colonization to induce precancerous conditions in Mongolian gerbils. Gastroenterology. 2005;128:1229-42 pubmed
    ..pylori to colonize the gastric corpus. This results in atrophic corpus-dominant gastritis, a severe precancerous condition, thus highlighting T4SS and CagA as major risk factors for gastric cancer development...
  5. Derendorf H, VanderMaelen C, Brickl R, MacGregor T, Eisert W. Dipyridamole bioavailability in subjects with reduced gastric acidity. J Clin Pharmacol. 2005;45:845-50 pubmed
    ..Substituting generic DP plus low-dose aspirin may be less effective than the buffered DP composite product in patients with concomitant antacid therapies. ..
  6. Sipponen P, Harkonen M. Hypochlorhydric stomach: a risk condition for calcium malabsorption and osteoporosis?. Scand J Gastroenterol. 2010;45:133-8 pubmed publisher
  7. Judd L, Andringa A, Rubio C, Spicer Z, Shull G, Miller M. Gastric achlorhydria in H/K-ATPase-deficient (Atp4a(-/-)) mice causes severe hyperplasia, mucocystic metaplasia and upregulation of growth factors. J Gastroenterol Hepatol. 2005;20:1266-78 pubmed
    Gastric neoplasia is common in humans, yet controversy remains over contributions of chronic achlorhydria, gastrinemia and hyperplasia, to cancer risk...
  8. Schiffmann R, Dwyer N, Lubensky I, Tsokos M, Sutliff V, Latimer J, et al. Constitutive achlorhydria in mucolipidosis type IV. Proc Natl Acad Sci U S A. 1998;95:1207-12 pubmed
  9. Sharma V, Brannon M, Carloss E. Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia. South Med J. 2004;97:887-9 pubmed date have failed to show a similar association with omeprazole, a proton pump inhibitor that also produces achlorhydria. These studies, however, have primarily involved nonanemic, iron-replete individuals...

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  1. Linderborg K, Marvola T, Marvola M, Salaspuro M, Farkkila M, Väkeväinen S. Reducing carcinogenic acetaldehyde exposure in the achlorhydric stomach with cysteine. Alcohol Clin Exp Res. 2011;35:516-22 pubmed publisher
    ..Achlorhydric atrophic gastritis is a well-known risk factor for gastric cancer. Achlorhydria leads to microbial colonization of the stomach...
  2. Ozutemiz A, Aydin H, Isler M, Celik H, Batur Y. Effect of omeprazole on plasma zinc levels after oral zinc administration. Indian J Gastroenterol. 2002;21:216-8 pubmed
    ..Zinc absorption decreased after omeprazole administration (141 [34] mg/dL/h) compared with pre-omeprazole values (245 [35]; p < 0.01). Suppression of gastric acid secretion by omeprazole reduces intestinal absorption of zinc. ..
  3. Tamura A, Kikuchi S, Hata M, Katsuno T, Matsui T, Hayashi H, et al. Achlorhydria by ezrin knockdown: defects in the formation/expansion of apical canaliculi in gastric parietal cells. J Cell Biol. 2005;169:21-8 pubmed
    Loss of gastric acid secretion is pathologically known as achlorhydria. Acid-secreting parietal cells are characterized by abundant expression of ezrin (Vil2), one of ezrin/radixin/moesin proteins, which generally cross-link actin ..
  4. Serrano C, Villagrán A, Toledo H, Crabtree J, Harris P. Iron Deficiency and IL1? Polymorphisms in Helicobacter pylori-infected Children. Helicobacter. 2016;21:124-30 pubmed publisher
    ..pylori-infected patients with ID compared to uninfected children. The established association between H. pylori infection and ID in children may be mediated by increased gastric mucosal IL-1?. ..
  5. Friis Hansen L, Rehfeld J. Impaired feedback of gastric functions in carboxypeptidase E-deficient mice. Biochem Biophys Res Commun. 2000;267:638-42 pubmed
    ..After induction of achlorhydria, however, neither the amount of alpha-amidated gastrin nor the total progastrin product increased in the fat/..
  6. Lodato F, Azzaroli F, Di Girolamo M, Feletti V, Cecinato P, Lisotti A, et al. Proton pump inhibitors in cirrhosis: tradition or evidence based practice?. World J Gastroenterol. 2008;14:2980-5 pubmed
    ..In conclusion, the use of this class of drugs seems more habit related than evidence-based eventually leading to an increase in health costs. ..
  7. Mason E, Munns J, Kealey G, Wangler R, Clarke W, Cheng H, et al. Effect of gastric bypass on gastric secretion. 1977. Surg Obes Relat Dis. 2005;1:155-60; discussion 161-2 pubmed
  8. Williams C. Occurrence and significance of gastric colonization during acid-inhibitory therapy. Best Pract Res Clin Gastroenterol. 2001;15:511-21 pubmed
    ..This chapter discusses these potential bacterial complications of therapeutic acid suppression and the evidence for them. ..
  9. Berk L, Castle W, Welch A, Heinle R, Anker R, Epstein M. Observations on the etiologic relationship of achylia gastrica to pernicious anemia. X. Activity of vitamin B12 food (extrinsic) factor. 1948. Nutr Hosp. 2004;19:387-90 pubmed
  10. Virili C, Trimboli P, Romanelli F, Centanni M. Liquid and softgel levothyroxine use in clinical practice: state of the art. Endocrine. 2016;54:3-14 pubmed
    ..In selected categories of levothyroxine-treated patients (pediatric, suffering from hypo-achlorhydria, polypharmacy, undergone bariatric surgery, fed through enteric tube) these new formulations have shown ..
  11. Merriman N, Putt M, Metz D, Yang Y. Hip fracture risk in patients with a diagnosis of pernicious anemia. Gastroenterology. 2010;138:1330-7 pubmed publisher
    Pernicious anemia (PA) is characterized by vitamin B-12 deficiency and achlorhydria, both of which have a detrimental effect on bone strength. The principle aim of this study was to determine the risk of hip fracture in patients with PA...
  12. Sánchez Fayos P, Martín Relloso M, González Guirado A, Porres Cubero J. [Gastric adenocarcinoma: approach to a complex biological reality]. Med Clin (Barc). 2007;128:21-30 pubmed
    ..A good knowledge of this complex biological reality will allow the identification of better markers for an early diagnosis as well as vulnerable etiopathogenetic points for a useful prevention and therapy. ..
  13. Kuwamura M, Okajima R, Yamate J, Kotani T, Kuramoto T, Serikawa T. Pancreatic metaplasia in the gastro-achlorhydria in WTC-dfk rat, a potassium channel Kcnq1 mutant. Vet Pathol. 2008;45:586-91 pubmed publisher
    ..The parietal cells in WTC-dfk rats were negative for KCNQ1 immunohistochemical analysis. These findings indicate that a deficiency in rat Kcnq1 provokes an abnormal proliferation and differentiation of gastric glandular cells. ..
  14. Ahsberg K, Olsson H, Staël von Holstein C. Increased mortality in prostate carcinoma and smoking-related disease after parietal cell vagotomy: a long-term follow-up study. Scand J Gastroenterol. 2009;44:947-51 pubmed publisher
    ..This might be the result of surgery-induced hypochlorhydria, which warrants further investigation in patients on long-term proton-pump inhibitors. ..
  15. Vilkin A, Levi Z, Morgenstern S, Shmuely H, Gal E, Hadad B, et al. Higher gastric mucin secretion and lower gastric acid output in first-degree relatives of gastric cancer patients. J Clin Gastroenterol. 2008;42:36-41 pubmed
    ..In patients with relatives with gastric cancer, H. pylori infection is associated with a more severe inflammatory reaction consisting of decreased gastric acid secretion and increased mucin secretion. ..
  16. Chandra M, Zhou H, Li Q, Muallem S, Hofmann S, Soyombo A. A role for the Ca2+ channel TRPML1 in gastric acid secretion, based on analysis of knockout mice. Gastroenterology. 2011;140:857-67 pubmed publisher
    ..An unusual feature of mucolipidosis type IV is constitutive achlorhydria. We produced Trpml1(-/-) (null) mice to investigate the requirement for this protein in gastric acid secretion...
  17. Khatami S, Mukunda B, Ravakhah K. Coinfection with Giardia lamblia and Clostridium difficile after use of ranitidine. Am J Med Sci. 2004;327:91-3 pubmed
    ..He had no other risk factors for these infections. Hence, we propose that ranitidine-induced hypochlorhydria predisposed this patient to the enteric infections. ..
  18. Agreus L, Kuipers E, Kupcinskas L, Malfertheiner P, Di Mario F, Leja M, et al. Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers. Scand J Gastroenterol. 2012;47:136-47 pubmed publisher
    ..Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach. ..
  19. George D, Watermeyer G, Levin D, Epstein D, Ross I, Scholz B, et al. Composite adrenal phaeochromocytoma-ganglioneuroma causing watery diarrhoea, hypokalaemia and achlorhydria syndrome. Eur J Gastroenterol Hepatol. 2010;22:632-4 pubmed publisher
    The watery diarrhoea, hypokalaemia and achlorhydria syndrome is a rare cause of secretory diarrhoea...
  20. Canani R, Cirillo P, Roggero P, Romano C, Malamisura B, Terrin G, et al. Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children. Pediatrics. 2006;117:e817-20 pubmed
    ..Additional studies are necessary to investigate the mechanisms of the increased risk of infections in children treated with GA inhibitors, and prophylactic measures could be considered in preventing them. ..
  21. Takagi T, Nishio H, Yagi T, Kuwahara M, Tsubone H, Tanigawa N, et al. Phenotypic analysis of vertigo 2 Jackson mice with a Kcnq1 potassium channel mutation. Exp Anim. 2007;56:295-300 pubmed
    ..Furthermore, vtg-2J/vtg-2J mice showed gastric achlorhydria associated with elevation of their serum gastrin levels...
  22. Argent R, Thomas R, Aviles Jimenez F, Letley D, Limb M, El Omar E, et al. Toxigenic Helicobacter pylori infection precedes gastric hypochlorhydria in cancer relatives, and H. pylori virulence evolves in these families. Clin Cancer Res. 2008;14:2227-35 pubmed publisher
    ..pylori increases cancer risk by causing this condition. Microevolution of virulence genes is common within families of gastric cancer patients and changes H. pylori virulence. ..
  23. Belei O, Heredea E, Boeriu E, Marcovici T, Cerbu S, Mărginean O, et al. Verner-Morrison syndrome. Literature review. Rom J Morphol Embryol. 2017;58:371-376 pubmed
    ..Watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome caused by VIP-producing tumors only rarely occurs in adult patients with non-pancreatic disease...
  24. Takaishi S, Cui G, Frederick D, Carlson J, Houghton J, Varro A, et al. Synergistic inhibitory effects of gastrin and histamine receptor antagonists on Helicobacter-induced gastric cancer. Gastroenterology. 2005;128:1965-83 pubmed
    ..felis/INS-GAS mice, while the proton pump inhibitor showed no such effects. These results support an important role for the gastrin-histamine axis in Helicobacter-induced gastric carcinogenesis. ..
  25. Afifi M, Abd El Aziz H, Hamed N, Barghash N, Abdo A, Gamal M. Role of Helicobacter pylori in refractory iron deficiency anaemia. Br J Biomed Sci. 2009;66:133-6 pubmed
    ..Thus, elevated serum TNF alpha in the H. pylori-seropositive group may be one of the underlying pathophysiological mechanism for iron deficiency anaemia observed in these patients. ..
  26. Hunyady B, Zolyomi A, Czimmer J, Mozsik G, Kozicz T, Buzas E, et al. Expanded parietal cell pool in transgenic mice unable to synthesize histamine. Scand J Gastroenterol. 2003;38:133-40 pubmed
    ..The HDC-/- strain is a suitable model for studying the effects of achlorhydria and consequent hypergastrinaemia as an approach to human conditions such as atrophic gastritis or long-term ..
  27. Morihara M, Aoyagi N, Kaniwa N, Kojima S, Ogata H. Assessment of gastric acidity of Japanese subjects over the last 15 years. Biol Pharm Bull. 2001;24:313-5 pubmed
    ..Considering the high percentage of achlorhydric elderly, bioavailability and bioequivalence studies should be performed taking into consideration the effects of gastric acidity on the in vivo performance of drug products. ..
  28. Bisanz A, Palmer J, Reddy S, Cloutier L, Dixon T, Cohen M, et al. Characterizing postoperative paralytic ileus as evidence for future research and clinical practice. Gastroenterol Nurs. 2008;31:336-44 pubmed publisher
    ..Clinical implications include the importance of encouraging early oral intake, monitoring fluid intake and output in postoperative patients, and identifying positive fluid balance early to prevent it from continuing. ..
  29. Harford W, Barnett C, Lee E, Perez Perez G, Blaser M, Peterson W. Acute gastritis with hypochlorhydria: report of 35 cases with long term follow up. Gut. 2000;47:467-72 pubmed
    ..One of several possible initial manifestations of H pylori acquisition in adults may be AGH. While H pylori colonisation usually persists, hypochlorhydria resolves in most subjects. ..
  30. Wang F, Xia P, Wu F, Wang D, Wang W, Ward T, et al. Helicobacter pylori VacA disrupts apical membrane-cytoskeletal interactions in gastric parietal cells. J Biol Chem. 2008;283:26714-25 pubmed publisher
    ..pylori-induced inhibition of acid secretion. Our results indicate that VacA disrupts the apical membrane-cytoskeletal interactions in gastric parietal cells and thereby causes hypochlorhydria...
  31. Othman F, Crooks C, Card T. The risk of Clostridium difficile infection in patients with pernicious anaemia: a retrospective cohort study using primary care database. United European Gastroenterol J. 2017;5:959-966 pubmed publisher
    ..The purpose of this study was to determine whether the mechanism by which PPIs induce an increased risk of C. difficile infection is supported by the same mechanism acting in another cause of achlorhydria, pernicious anaemia.
  32. El Omar E, Oien K, El Nujumi A, Gillen D, Wirz A, Dahill S, et al. Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology. 1997;113:15-24 pubmed
    ..In some subjects, chronic H. pylori infection produces a body-predominant gastritis and profound suppression of gastric acid secretion that is partially reversible with eradication therapy. ..
  33. Moncur P, Heatley R. Safety of proton-pump inhibitors: the acid test. Eur J Gastroenterol Hepatol. 2000;12:145-7 pubmed
    ..This hypothesis has led to concerns about the safety of long-term acid suppression in the management of a variety of acid-related gastrointestinal conditions. ..
  34. Sugawara M, Kadomura S, He X, Takekuma Y, Kohri N, Miyazaki K. The use of an in vitro dissolution and absorption system to evaluate oral absorption of two weak bases in pH-independent controlled-release formulations. Eur J Pharm Sci. 2005;26:1-8 pubmed
    ..of these preparations in gastric pH conditions similar to those in healthy subjects and patients with achlorhydria were compared with those of a physical mixture and commercial tablets...
  35. Tucci A, Poli L, Biasco G, Paparo G, Tosetti C, Fusaroli P, et al. Helicobacter pylori infection and gastric function in patients with fundic atrophic gastritis. Dig Dis Sci. 2001;46:1573-83 pubmed
    ..patients with preserved acid secretion (Group 1), patients with hypochlorhydria (Group 2), and patients with achlorhydria (Group 3)...
  36. Nakamura E, Kataoka T, Furutani K, Jimbo K, Aihara T, Tanaka S, et al. Lack of histamine alters gastric mucosal morphology: comparison of histidine decarboxylase-deficient and mast cell-deficient mice. Am J Physiol Gastrointest Liver Physiol. 2004;287:G1053-61 pubmed
    ..These results indicate that enterochromaffin-like cell-derived histamine is potentially involved in gastric mucosal morphology regulation. ..
  37. Ayazi S, Leers J, Oezcelik A, Abate E, Peyre C, Hagen J, et al. Measurement of gastric pH in ambulatory esophageal pH monitoring. Surg Endosc. 2009;23:1968-73 pubmed publisher
    ..Negative 24-h esophageal pH test results for a patient with hypochlorhydria may prompt a search for nonacid reflux as the explanation for the patient's symptoms. ..
  38. Afshan S, Farah Musa A, Echols V, Lerant A, Fulop T. Persisting Hypocalcemia After Surgical Parathyroidectomy: The Differential Effectiveness of Calcium Citrate Versus Calcium Carbonate With Acid Suppression. Am J Med Sci. 2017;353:82-86 pubmed publisher
    ..1-8.3mg/dL). This current case and the included literature review emphasize the disproportionate effectiveness of Ca citrate in subjects with achlorhydria.
  39. Zhang P, Zhang Y, Zhang C, Shi Y, Liu J, Liu Q, et al. [Subtype classification and clinicopathological characteristics of gastric neuroendocrine neoplasms: an analysis of 241 cases]. Zhonghua Wei Chang Wai Ke Za Zhi. 2016;19:1241-1246 pubmed
    ..and pathological grade, patients with gastric NEN were divided into 4 types: type I( (hypergastrinemia and achlorhydria, related to autoimmune chronic atrophic gastritis), type II( [hypergastrinemia and Zollinger-Ellison syndrome, ..
  40. de Martel C, Ratanasopa S, Passaro D, Parsonnet J. Validation of the blood quininium resin test for assessing gastric hypochlorhydria. Dig Dis Sci. 2006;51:84-8 pubmed
    ..In its current formulation, the bQRT's low specificity makes it less useful in low-risk population. ..
  41. Williams C, McColl K. Review article: proton pump inhibitors and bacterial overgrowth. Aliment Pharmacol Ther. 2006;23:3-10 pubmed
    ..Further research to more fully quantify the risk associated with PPI therapy is required. ..
  42. Parsons B, Ijaz U, D Amore R, Burkitt M, Eccles R, Lenzi L, et al. Comparison of the human gastric microbiota in hypochlorhydric states arising as a result of Helicobacter pylori-induced atrophic gastritis, autoimmune atrophic gastritis and proton pump inhibitor use. PLoS Pathog. 2017;13:e1006653 pubmed publisher
    ..Autoimmune and H. pylori-induced atrophic gastritis were associated with different gastric microbial profiles. PPI treated patients showed relatively few alterations in the gastric microbiota compared to healthy subjects...
  43. Iwai W, Abe Y, Iijima K, Koike T, Uno K, Asano N, et al. Gastric hypochlorhydria is associated with an exacerbation of dyspeptic symptoms in female patients. J Gastroenterol. 2013;48:214-21 pubmed publisher
    ..Differences in the responsiveness to gastric hypochlorhydria between males and females may be partly responsible for the gender differences in the prevalence and severity of dyspeptic symptoms. ..
  44. Gawenis L, Greeb J, Prasad V, Grisham C, Sanford L, Doetschman T, et al. Impaired gastric acid secretion in mice with a targeted disruption of the NHE4 Na+/H+ exchanger. J Biol Chem. 2005;280:12781-9 pubmed
  45. Hold G, Rabkin C, Chow W, Smith M, Gammon M, Risch H, et al. A functional polymorphism of toll-like receptor 4 gene increases risk of gastric carcinoma and its precursors. Gastroenterology. 2007;132:905-12 pubmed
    ..4). Our data suggest that the TLR4+896A>G polymorphism is a risk factor for noncardia gastric carcinoma and its precursors. The findings underscore the role of the host innate immune response in outcome of H pylori infection. ..
  46. Nakayama S, Yokote T, Kobayashi K, Hirata Y, Hiraiwa T, Komoto I, et al. VIPoma with expression of both VIP and VPAC1 receptors in a patient with WDHA syndrome. Endocrine. 2009;35:143-6 pubmed publisher
    ..This is the first case report of a VIPoma that immunostains for VIP and VPAC1 receptors and indicates that abundant VIP produced by VIPoma might inhibit its growth and reduce VIP secretion via the VPAC1 receptor in vivo...
  47. Argani P, Choti M, Abraham S. Achlorhydria, parietal cell hyperplasia, and multiple gastric carcinoids: a new disorder. Am J Surg Pathol. 2007;31:488 pubmed
  48. Doki K, Darwich A, Patel N, Rostami Hodjegan A. Virtual bioequivalence for achlorhydric subjects: The use of PBPK modelling to assess the formulation-dependent effect of achlorhydria. Eur J Pharm Sci. 2017;109:111-120 pubmed publisher
    ..We therefore examined achlorhydria-related disparity in bioequivalence of levothyroxine and nifedipine formulations using virtual bioequivalence ..
  49. Cave D. Helicobacter pylori and its interaction with chief and parietal cells. Yale J Biol Med. 1996;69:91-8 pubmed
    ..The effects are clinically evident, and long-term achlorhydria may be a risk factor for gastric cancer...
  50. Goldin E, Caruso R, Benko W, Kaneski C, Stahl S, Schiffmann R. Isolated ocular disease is associated with decreased mucolipin-1 channel conductance. Invest Ophthalmol Vis Sci. 2008;49:3134-42 pubmed publisher
    ..15-year-old boy with MLIV (mucolipidosis type IV) and clinical abnormalities restricted to the eye who also had achlorhydria with elevated blood gastrin levels...
  51. Gaddy J, Radin J, Loh J, Zhang F, Washington M, Peek R, et al. High dietary salt intake exacerbates Helicobacter pylori-induced gastric carcinogenesis. Infect Immun. 2013;81:2258-67 pubmed publisher
    ..Animals infected with the cagA mutant strain had low levels of gastric inflammation and did not develop hypochlorhydria. These results indicate that a high-salt diet potentiates the carcinogenic effects of cagA(+) H. pylori strains. ..
  52. Furuta T, El Omar E, Xiao F, Shirai N, Takashima M, Sugimura H, et al. Interleukin 1beta polymorphisms increase risk of hypochlorhydria and atrophic gastritis and reduce risk of duodenal ulcer recurrence in Japan. Gastroenterology. 2002;123:92-105 pubmed
    ..The effects are dependent on H. pylori infection and become more significant with advancing age. This may explain the high incidence of gastric cancer in Japan and also the age-dependent decrease in DU recurrence in infected subjects. ..
  53. Roepke T, Anantharam A, Kirchhoff P, Busque S, Young J, Geibel J, et al. The KCNE2 potassium channel ancillary subunit is essential for gastric acid secretion. J Biol Chem. 2006;281:23740-7 pubmed
    ..gastric phenotype with profoundly reduced parietal cell proton secretion, abnormal parietal cell morphology, achlorhydria, hypergastrinemia, and striking gastric glandular hyperplasia arising from an increase in the number of non-..