- 関
- achylic、hyposecretion
WordNet
- absence of gastric juices (partial or complete) (同)achylia_gastrica
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/11 16:40:00」(JST)
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This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2013) |
| Achlorhydria |
| Classification and external resources |
Hydrogen chloride (major component of gastric acid)
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| ICD-10 |
K31.8 |
| ICD-9 |
536.0 |
| DiseasesDB |
29513 |
| eMedicine |
med/18 |
| MeSH |
D000126 |
Achlorhydria // or hypochlorhydria refers to states where the production of gastric acid in the stomach is absent or low, respectively. It is associated with various other medical problems.
Contents
- 1 Signs and symptoms
- 2 Causes
- 3 Diagnosis
- 4 Treatment
- 5 Prognosis
- 6 References
- 7 See also
Signs and symptoms[edit]
The decreased acid level itself can cause symptoms similar to gastroesophageal reflux disease, and impairs protein digestion by inhibiting the activation of the enzyme pepsin, whose activation is dependent upon a low gastric pH. Furthermore, low acid (high pH) levels in the stomach are linked with bacterial overgrowth (as the stomach does not kill microbes normally present in food), which can manifest as diarrhea or decreased absorption of nutrients or vitamins. Risk of particular infections, such as Vibrio vulnificus (commonly from seafood) is increased. Even without bacterial overgrowth, low stomach acid (high pH) can lead to nutritional deficiencies through malabsorption of basic electrolytes (magnesium, zinc, etc.) and vitamins (including vitamin C, vitamin K, and the B complex of vitamins). Such deficiencies may be involved in the development of a wide range of pathologies, from fairly benign neuromuscular issues to life-threatening diseases. A person with achlorhydria can suffer from stomach pains caused by the digestion of food that is not properly broken down by gastric acid.
Causes[edit]
- The slowing of the body's basal metabolic rate associated with hypothyroidism
- Autoimmune disorders where there is antibody production against parietal cells which normally produce gastric acid.
- The use of antacids or drugs that decrease gastric acid production (such as H2-receptor antagonists) or transport (such as proton pump inhibitors).
- A symptom of rare diseases 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.[1]
- A symptom of pernicious anemia, atrophic gastritis or of stomach cancer.
- Radiation therapy involving the stomach.
- Gastric bypass procedures such a duodenal switch and RNY, where the largest acid producing parts of the stomach are either removed, or blinded.
- VIPomas (vasoactive intestinal peptides) and somatostatinomas are both islet cell tumors of the pancreas.
- Pellagra, caused by niacin deficiency.
Diagnosis[edit]
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This diagnosis needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (May 2013) |
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.
Treatment[edit]
Treatment focuses on addressing the underlying cause of symptoms. With Helicobacter pylori induced achlorhydria, antibiotic treatment is usually prescribed, though it may not always reverse the condition completely.[2]
Prognosis[edit]
Little is known on the prognosis of achlorhydria, although there have been reports of an increased risk of gastric cancer.[3] A 2007 review article noted that non-Helicobacter bacterial species can be cultured from achlorhydric (pH > 4.0) stomachs, whereas normal stomach pH only permits the growth of Helicobacter species. Furthermore, experiments with achlorhydric mice have shown that non-Helicobacter bacteria can induce atrophic gastritis, which, in turn, can cause gastric carcinoma.[4]
References[edit]
- ^ El-Omar EM, Oien K, El-Nujumi A et al. (1997). "Helicobacter pylori infection and chronic gastric acid hyposecretion". Gastroenterology 113 (1): 15–24. doi:10.1016/S0016-5085(97)70075-1. PMID 9207257.
- ^ Iijima, K.; Sekine, H.; Koike, T.; Imatani, A.; Ohara, S.; Shimosegawa, T. (2004). "Long-term effect of Helicobacter pylori eradication on the reversibility of acid secretion in profound hypochlorhydria". Alimentary Pharmacology and Therapeutics 19 (11): 1181–1188. doi:10.1111/j.1365-2036.2004.01948.x. PMID 15153171. edit
- ^ Svendsen JH, Dahl C, Svendsen LB, Christiansen PM (1986). "Gastric cancer risk in achlorhydric patients. A long-term follow-up study". Scand. J. Gastroenterol. 21 (1): 16–20. doi:10.3109/00365528609034615. PMID 3952447.
- ^ Fox JG, Wang TC (2007). "Inflammation, atrophy, and gastric cancer.". J Clin Invest. 117 (1): 60–69. doi:10.1172/JCI30111.. PMID 17200707.
See also[edit]
- Hyperchlorhydria
- Isopropamide
- Fundic gland polyposis
English Journal
- A prospective evaluation of the effect of chronic proton pump inhibitor use on plasma biomarker levels in humans.
- Raines D, Chester M, Diebold AE, Mamikunian P, Anthony CT, Mamikunian G, Woltering EA.SourceFrom the *Section of Gastroenterology, Department of Medicine, †Stanley S. Scott Cancer Center, and ‡Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; §Inter Science Institute, Inglewood, CA; and ∥Sections of Endocrine Surgery and Surgical Oncology, Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
- Pancreas.Pancreas.2012 May;41(4):508-11.
- OBJECTIVE: Proton pump inhibitors (PPIs) are used primarily to treat gastroesophageal reflux disease. Proton pump inhibitor-induced achlorhydria increases circulating gastrin and chromogranin A (CGA). Chromogranin is a widely used biomarker for the diagnosis and follow-up for gut-based neuroendocrin
- PMID 22460728
- Pheochromocytoma with Histological Transformation to Composite Type Presenting Watery Diarrhea, Hypokalemia, Achlorhydria Syndrome.
- Kikuchi Y, Wada R, Sakihara S, Suda T, Yagihashi S.SourceDepartment of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho Hirosaki 036-8562, Japan.
- Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.Endocr Pract.2012 Mar 22:1-10. [Epub ahead of print]
- Objective: Histological transformation of pheochromocytoma (PC) to composite type is a very rare. We describe clinicopathological features of a case, which transformed from PC to composite type and complicated with watery diarrhea, hypokalemia and achlorhydria syndrome.Methods: A 12 year-old girl pr
- PMID 22440998
Japanese Journal
- Achylia and the development of gastric carcinoids
- Achylia,pernicious anaemia,ECL cells and gastric carcinoids
- Achylia患者の消化管における市販塩酸プロカインアミド錠の崩壊性
- 村松 修吾,小坂 忠雄,伊藤 久雄,大山 克已,板原 克哉
- 病院薬学 3(2), 80-87, 1977-08-20
- … It was found in a test of the gastric juice that the patient had gastric achylia where the acidity of gastric juice might have prevented the disintegration. … The fact seems important to discuss because gastric achylia is not a rare symptom and because the drug is excreted without any effect in such patient. …
- NAID 110001796662
Related Links
- achylia [ah-ki´le-ah] absence of hydrochloric acid and enzymes in the gastric secretions. ach·y·li·a (ă-kī'lē-ă), 1. Absence of gastric juice or other digestive secretions. 2. Absence of chyle. [G. a-priv. + chylos, juice] achylia /achy·lia/ (ah-ki´le-ah ...
- Thesaurus Antonyms Related Words Synonyms Legend: Switch to new thesaurus Noun 1. achylia - absence of gastric juices (partial or complete) achylia gastrica disorder, upset - a physical condition in which there is a disturbance ...
Related Pictures
★リンクテーブル★
[★]
- 英
- hyposecretion、achylia
- 関
- 無酸
[★]
- 英
- achylia、achylic
- 関
- 分泌過少
[★]
- 関
- achylia
[★]
- 関
- achylia