Overview

Hypochlorhydria is a condition of the stomach in which the amount of digestive juices (hydrochloric acid) is reduced. This can lead to poor digestion of proteins, as well as other gastrointestinal disturbances. If untreated, chronic hypochlorhydria can lead to Helicobacter pylori infection, malnutrition, and possibly autoimmune diseases.

Signs and Symptoms

Symptoms often occur 30 minutes to an hour after eating a meal containing protein, and may include:

Other signs and symptoms may be noticed over a longer period of time, including:

Etiology

Differential Diagnosis

Sequelae

Pathophysiology

Adequate levels of stomach acid are required to close both the esophageal and pyloric sphincters. If the esophageal sphincter does not close tightly, gastro-esophageal reflux (GERD) may occur as gastric juices pass up the throat. If the pyloric sphincter does not close tightly, basic digestive juices from the duodenum may pass up into the stomach, irritating the gastric lining.

Acidic solution is required to absorb minerals such as iron and calcium. Chronic hypochlorhydria may result in inadequate absorption of these important minerals.

Acid from the stomach is needed to stimulate the release of pancreatic digestive fluids into the duodenum. Insufficient acid may result in pancreatic deficiency as well.

Acid in stomach forms a physical barrier to many bacteria, including Helicobacter pylori. Inadequate stomach acid predisposes the patient to a variety of gastrointestinal infections and dysbiosis.

Hydrochloric acid is generated by the same cells in the stomach that release "intrinsic factor", which is required for the absorption of vitamin B-12 in the intestine. Reduced HCl production leads to a concomitant reduction in intrinsic factor, which can lead to anemia.

ICD-9 Codes

ICD9-CodeDescriptionComments
537.9Unspecified stomach disorder 

References

Unless specifically noted above, references used in the construction of this web page include the following:

[FDM] Lecture notes from Functional Medicine University.

[SCNM] Lecture notes from Southwest College of Naturopathic Medicine.

[UT] Lecture notes from the University of Tennessee graduate programs in Chemistry and Biochemistry.

[Kharrazian2010]. Kharrazian D. Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? Morgan-James (2010).