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What is achlorhydria, causes, symptoms, and treatment

Achlorhydria is a situation characterized by the absence of hydrochloric acid (HCl) production by the stomach, increasing the local pH and leading to the appearance of symptoms that can be quite uncomfortable for the person, such as nausea, abdominal swelling, weakness and gastroesophageal reflux.

This situation can have several causes, however, it is more often associated with chronic infection by the bacterium Helicobacter pylori ( H. pylori ), but it can also happen as a consequence of the use of medications or autoimmune diseases. Due to the various causes of achlorhydria, treatment may vary according to the cause, and it is important that it be done according to the gastroenterologist’s recommendation so that there is an improvement in symptoms.

Causes of achlorhydria

Achlorhydria is most often caused by atrophy of the stomach, and is often related to autoimmune gastritis and chronic gastritis, and is also usually related to infection by the bacteria H. pylori . In addition, achlorhydria can be caused by autoimmune diseases, use of drugs to decrease stomach acidity and hypothyroidism, for example.

This situation is more common in people who are over 60 and have already undergone surgical procedures on the stomach.

Main symptoms

The signs and symptoms of achlorhydria are related to the absence of hydrochloric acid and elevated stomach pH, ​​and there may be:

  • Sickness;
  • Reflux;
  • Abdominal discomfort and swelling;
  • Weakness;
  • Diarrhea or constipation;
  • Decreased absorption of nutrients such as calcium, folic acid, iron and vitamins C and D, with malnutrition possible;
  • Hair loss;
  • Indigestion;
  • Weight loss.

In addition, as in achlorhydria the absence of intrinsic factor release by parietal stomach cells is common, it is also common for the person to develop pernicious anemia, which is a type of anemia characterized by vitamin B12 deficiency. This is because the intrinsic factor is also responsible for promoting the absorption of this vitamin in the body. Learn how to identify pernicious anemia.

Another type of anemia that people with achlorhydria can develop is iron deficiency anemia, also known as iron deficiency anemia, since hydrochloric acid also helps in the iron absorption process.

What is the difference between hypochlorhydria and achlorhydria?

Unlike achlorhydria, hypochlorhydria is characterized by decreased hydrochloric acid production. That is, the stomach cells are still capable of producing and secreting HCl in the stomach, however in smaller quantities, which also causes the pH of the stomach to increase and lead to the appearance of signs and symptoms that can be quite uncomfortable. Learn more about hypochlorhydria.

How the treatment is done

The treatment of achlorhydria varies according to the cause and, therefore, it is important that the person reports all the symptoms presented to the gastroenterologist or general practitioner and also performs all the requested tests, as it is possible for the doctor to indicate the most appropriate treatment. . However, depending on the cause, the treatment may not be able to completely restore the production of hydrochloric acid, but rather capable of slightly increasing the amount of secreted HCl, characterizing hypochlorhydria.

If achlorhydria is related to H. pylori infection, the use of antibiotics to treat the infection and avoid other infections that may occur more frequently in people with achlorhydria may be indicated. If it is caused by the use of medications, the doctor must evaluate the possibility of changing or suspending the medication.

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