In order to assess a patient suspected of suffering from achlorhydria, a detailed medical history should be obtained. A physician should evaluate the corresponding risk factors: Gastric bypass surgery, chronic PPI use, persisting H. pylori infection and autoimmune diseases (eg, diabetes, autoimmune thyroid disease).

In order to determine the existence of possible complications arising from achlorhydria (bacterial overgrowth, intestinal metaplasia, hip fracture) additional questions are of vital importance. A doctor will investigate the presence of weight loss, feeling of fullness too early in the course of a meal, bowel movement frequency, abdominal discomfort and bloating, as well as potential reflux symptoms. Patients should also undergo tests to determine a possible anemia, since an acidic pH mediates the absorption of iron and achlorhydric patients often develop iron deficiency and subsequent anemia [11].

A lack of various nutrients resulting from a possible bacterial overgrowth can also lead to neurological symptoms. For this reason, a corresponding medical history, including the existence of visual changes, hallucinations, paresthesias, ataxia, numbness, gait imbalance, memory impairment, personality and mood alterations, should not be omitted.

• Weakness

  Deficiencies in certain nutrients may result in limb weakness, memory or mood changes, numbness and tingling in the limbs or cause other symptoms. [verywellhealth.com]

  Abstract In this study, two dissolution models were developed to achieve in vitro-in vivo relationship for immediate release formulations of Compound-A, a poorly soluble weak base with pH-dependent solubility and low bioavailability in hypochlorhydric [ncbi.nlm.nih.gov]

  B12 is probably the most common) undigested food in stools weak, brittle nails (Sources: HERE and HERE ) Like hypochlorhydria, the risk for achlorhydria increases with age (stomach acid decreases with age). [agutsygirl.com]

  […] esp. lower limbs with myalgia paraesthesia ataxia and gait disorders ;also psychological disorders like weak memory, mood disorders personality disorders, hallucinations etc. these patients are prone to infection of Vibrio Vulnificus and other usually [atomictherapy.org]

• Pallor

  Symptoms Symptoms of pernicious anemia include fatigue, weakness, waxy pallor, shortness of breath, rapid heartbeat, unsteady gait, smooth tongue, gastrointestinal disturbances, and neurological problems. [britannica.com]

  The classical components of the syndrome include: - SIDEROPENIA & HYPOCROMIC MICROCYTIC ANEMIA Symptoms resulting from anemia (weakness, pallor, fatigue, tachycardia) may dominate the clinical picture. - DYSPHAGIA & ODINOPHAGIA The dysphagia is usually [flipper.diff.org]

• Malaise

  • Discomfort in throat • Malaise • Low grade fever • Pharynx is congested but no lymphadenopathy Mild • Pain in throat • Dysphagia • Headache • Malaise • High fever • Pharynx shows erythema, exudate • Enlargement of tonsils and lymphoid follicles on [slideshare.net]

  […] e.g. digestive upsets, an occasional sense of fullness when only small amounts of food are eaten, heartburn, frequent belching, indigestion, abdominal discomfort or pain, loose stools up to three times per day or constipation, glossitis, and general malaise [orthomolecular.org]

• Underweight

  Hypochlorhydric child is often mal-absorption and underweight. It is unusual to see an overweight child with asthma. [gastrodigestivesystem.com]

• Weight Gain

  gain around the upper and mid abdomen. [ndhealthfacts.org]

• Sore Throat

  Throats Dec. 18, 2017 — The use of probiotics and xylitol chewing gum to alleviate sore throat symptoms -- as an alternative to antibiotics -- appears to have no effect, according to a randomized controlled trial ... read more Persistent Sore Throat [sciencedaily.com]

  You must have: a sore throat caused by tonsillitis episodes of sore throat that are disabling and stop you functioning normally seven or more well-documented, clinically significant, adequately treated sore throats in the preceding year or five or more [nhsinform.scot]

  throat and high fever May occur as a component of hand, foot, and mouth disease Herpetic pharyngotonsillitis/herpetic gingivostomatitis HSV-1 Multiple small oral lesions located in the anterior oropharynx and lips Fever, sore throat, pharyngeal redness [amboss.com]

  Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. [mayoclinic.org]

• Cough

  […] or sneeze into a tissue or, when necessary, into his or her elbow Teach your child to wash his or her hands after sneezing or coughing Dec. 13, 2018 [mayoclinic.org]

  Modified Centor score [5] A set of criteria used to estimate the probability that pharyngitis is caused by GAS Think of M-CENTOR to remember the Modified Centor score criteria: M = Must be older than 3 years, C = Cough absent, E = Exudate on the tonsils [amboss.com]

  List of side effects http://www.drugs.com/sfx/diflucan-side-effects.html Abdominal or stomach pain chills clay-colored stools cough dark urine diarrhea difficulty with swallowing dizziness fast heartbeat fever general feeling of tiredness or weakness [rawpaleodietforum.com]

  tendency to cough as throat is irritable 38. [slideshare.net]

  Occasionally, the bleeding can be more severe, causing people to cough up blood. Seek immediate medical advice if this happens. You should be given an emergency contact number before you're discharged from hospital. [nhsinform.scot]

• Respiratory Distress

  distress syndrome, and particularly, septic shock from overlying infection. [archbronconeumol.org]

• Dyspnea

  […] experiencing a cold epidemic with rhinorrhea, dry cough and mild wheezing and she said her health deteriorated progressively, with headache, earache, pain on swallowing, nausea without vomiting, constipation, pleuritic-type bilateral chest pain, and slight dyspnea [archbronconeumol.org]

• Constipation

  Signs and symptoms The signs and symptoms associated with achlorhydria include gastric reflux, abdominal bloating and discomfort, early satiety, stomach infections, diarrhea, constipation, malabsorption of food, and weight loss. [xpertdox.com]

  […] achlorhydria can result as known complications of bacterial overgrowth and intestinal metaplasia and symptoms are often consistent with those diseases: gastroesophageal reflux disease (source needed) abdominal discomfort early satiety weight loss diarrhea constipation [en.wikipedia.org]

• Dysphagia

  The improvement in dysphagia after iron therapy provides evidence for an association between iron deficiency and postcricoid dysphagia. [flipper.diff.org]

  […] the most common symptoms encountered Patients use the term to describe almost any feeling in the throat, ranging from dryness to actual pain – important to ascertain the precise nature of sore throat & severity early in clinical history Severity – dysphagia [slideshare.net]

  […] stomach to your abdomen or chest, or even up into your throat Regurgitation: a sour or bitter-tasting acid backing up into your throat or mouth Other symptoms of acid reflux disease include: Bloating Bloody or black stools or bloody vomiting Burping Dysphagia [webmd.com]

  […] polymicrobial infections with aerobic bacteria (typically streptococci, staphylococci, Haemophilus influenzae) and anaerobic bacteria [2] Clinical features Sudden onset of symptoms Red and swollen pharynx, tonsillar exudates [3] Fever, sore throat, dysphagia [amboss.com]

  Generally, patients develop following symptoms which are listed in order of their prevalence: Epigastric pain Weight loss Heartburn Nausea Bloating Diarrhea Abdominal pain Acid regurgitation Early satiety Vomiting Postprandial fullness Constipation Dysphagia [ncbi.nlm.nih.gov]

• Dyspepsia

  Quality of life in functional dyspepsia. Dig Dis Sci 2002: 47(1): 20-6. [ Links ] 132. Delaney BC, Moayyedi P, Forman D. Initial management strategies for dyspepsia. Cochrane Database Syst Rev 2003: CD001961. [ Links ] 133. [scielo.isciii.es]

  […] exercise and gastric acid secretion PubMed Chiarioni G et al, 2008, Hypnosis and upper digestive function and disease PubMed Klein KB et al, 1989, Modulation of gastric acid secretion by hypnosis PubMed Bortolotti M et al, 2002, The treatment of functional dyspepsia [nutrientsreview.com]

  Reported symptoms often relate to indigestion or functional dyspepsia developing during or after meals. 13 Complaints such as gas, bloating, muscle cramps, epigastric heaviness and easy satiety can relate to a hypochlorhydric state, although the condition [ndnr.com]

  It is also a known fact that gastric atrophy is directly linked to intestinal metaplasia and increases the risk of patients for developing a gastric adenocarcinoma, by 2 or 3 times. 16% of patients suffering from dyspepsia have been diagnosed with gastric [symptoma.com]

  The most common cause for achlorhydria is treatment of gastroduodenal ulcers, nonulcer dyspepsia, or gastroesophageal reflux with proton pump inhibitors (substituted benzimidazoles, eg, omeprazole). [neurology.testcatalog.org]

• Loss of Appetite

  […] of appetite nausea and vomiting puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue shortness of breath skin rash stomach pain, continuing tightness in the chest unpleasant breath odor unusual tiredness or weakness upper right [rawpaleodietforum.com]

  Other symptoms include: Throat pain or tenderness Red tonsils A white or yellow coating on your tonsils Painful blisters or ulcers on your throat Headache Loss of appetite Ear pain Trouble swallowing Swollen glands in your neck or jaw Fever and chills [webmd.com]

  Itchiness around the rectum Loss of appetite for meat Skin and Nail Symptoms Rosy cheeks due to capillary dilatation in the cheeks Weak, peeling or cracked fingernails that break easily Acne Hair loss in females Naturopathic Treatment The goal of naturopathic [ndhealthfacts.org]

• Delayed Gastric Emptying

  ‘Malabsorption may be caused by delayed gastric emptying, prior or concurrent injury, achlorhydria, and reduced gastric mucin secretion.’ [lexico.com]

• Urticaria

  […] frequent finding in microcytic anemia, 1, 2 hyperthyroidism 3 and chronic arthritis. 4 For many years dilute hydrochloric acid has been employed in various dermatologic disorders, particularly acne rosacea, and more recently it has been recommended for urticaria [nejm.org]

  Conditions Osteoporosis Rheumatoid arthritis Blood Conditions Anemia and pernicious anemia Endocrine Conditions Addison's disease Diabetes mellitus Hyperthyroidism Hypoglycemia Thyroid Diseases Skin Conditions Dry Skin Acne Eczema Psoriasis Rosacea Urticaria [ndhealthfacts.org]

  A wide number of extraintestinal conditions have been related to H. pylori infection -ischemic heart disease, rosacea, idiopathic chronic urticaria, alopecia areata, diabetes mellitus, autoimmune thyroiditis, Sjögren's syndrome, Raynaud's syndrome, Schönlein-Henoch [scielo.isciii.es]

• Muscle Cramp

  The most common presentation includes chronic watery diarrhea (described as >3L/day, odorless, blood and mucus free and unaffected by fasting), hypokalemia (manifesting with muscle weakness, abdominal muscle cramps, or respiratory depression), and various [orpha.net]

  Signs may include deficiencies of vitamins and minerals, muscle cramps and twitches, acne, food allergies, dilated capillaries on cheeks and nose, brittle and peeling nails, and halitosis. 11,13 Neurological symptoms due to nerve demyelination, including [ndnr.com]

• Muscle Spasm

  […] pain loss of bladder control lower back or side pain mood changes muscle pain or cramps muscle spasm or jerking of all extremities numbness or tingling in the hands, feet, or lips painful or difficult urination pale skin red skin lesions, often with [rawpaleodietforum.com]

• Foreign Body Sensation

  Symptoms : • Discomfort or pain in the throat - especially in the morning • Foreign body sensation in throat - has constant desire to swallow or clear his throat to get rid of ‘foreign body’ • Tiredness of voice - cannot speak for long, voice lose quality [slideshare.net]

• Hunger

  Symptoms There are a wide range of symptoms associated with hypochlorydria including: Digestive Symptoms Abdominal bloating, especially when consuming animal protein Burping Flatulence or gas typically right after eating Indigestion Diarrhea Constipation Hunger [ndhealthfacts.org]

• Seizure

  Lapin IP, Nicotinamide, inosine and hypoxanthine, putative endogenous ligands of the benzodiazepine receptor, opposite to diazepam are much more effective against kynurenine-induced seizures than against pentylenetetrazol-induced seizures. [townsendletter.com]

• Agitation

  Les réactions les plus fréquemment rapportées sont les suivantes : sensations vertigineuses, troubles sensoriels (y compris paresthésies), troubles du sommeil (y compris insomnie et rêves intenses), agitation ou anxiété, nausées et/ou vomissements, tremblements [viva.ca]

The first step towards the diagnosis of a suspected achlorhydria is the evaluation of gastric pH. Gastric fluid is collected via naso- or orogastric tubes following the patient's fasting. pH values >3.5 constitute a definite sign of achlorhydria [12]. Further tests may be used to determine the concentration of gastrin in blood, which is usually high in achlorhydric patients. Levels of pepsinogen A (PgA) in the blood are also used to determine the existence of achlorhydria, with levels <17 mcg/L being a strong indication of the condition. Pepsinogen is also an enzyme mediating the digestion of food [13].

Another useful test towards the diagnosis of achlorhydria involves the evaluation of gastric bacterial overgrowth, since it is a state that is many times responsible for hypo- or achlorhydria. This can be performed with a gastric or upper intestinal aspirate culture, with a breath test that assesses the release of hydrogen after a patients ingests plain sugar or a breath test involving the ingestion of specific, radioactive sugar. In the latter method, radioactive sugar is actually digested by gastric bacteria; should an overgrown population exist intragastrically, the patient is expected to exhale large amounts of radioactivity, a product of bacterial digestion.

• Hypochlorhydria

  (pernicious anemia, chronic atrophic gastritis, certain autoimmune diseases) Prior gastric bypass surgery Hypochlorhydria and achlorhydria increase with age. [verywellhealth.com]

  Keywords Gastric juice, achlorhydria, hypochlorhydria, gastric acidity determination [hero.epa.gov]

  […] cancer of the stomach Wiktionary (0.00 / 0 votes) Rate this definition: achlorhydria (Noun) The production of an abnormally small amount of hydrochloric acid in the stomach Freebase (0.00 / 0 votes) Rate this definition: Achlorhydria Achlorhydria or hypochlorhydria [definitions.net]

  CONCLUSIONS: We have identified a 14.8% false-positive rate in SST in patients with hypochlorhydria or achlorhydria. [ncbi.nlm.nih.gov]

  In other words, whereas hypochlorhydria indicates very little stomach acid, achlorhydria indicates almost no stomach acid. Hypochlorhydria is already associated with all the low-stomach acid problems, but with achlorhydria, there might be even more. [agutsygirl.com]

• Microcytic Anemia

  It has been reported a frequent finding in microcytic anemia, 1, 2 hyperthyroidism 3 and chronic arthritis. 4 For many years dilute hydrochloric acid has been employed in various dermatologic disorders, particularly acne rosacea, and more recently it [nejm.org]

  The classical components of the syndrome include: - SIDEROPENIA & HYPOCROMIC MICROCYTIC ANEMIA Symptoms resulting from anemia (weakness, pallor, fatigue, tachycardia) may dominate the clinical picture. - DYSPHAGIA & ODINOPHAGIA The dysphagia is usually [flipper.diff.org]

Intervention in cases of achlorhydric patients is individualized depending on the cause of the condition:

• H. pylori infection: Possible need for antibiotics and PPIs [14]. The treatment regime is continued for 14 days or more to achieve a radical elimination of bacteria. Additional courses may be necessary, should the re-assessment reveal a persisting H. pylori infection.
• Tumors: Combination of surgical excision and chemotherapy and/or radiation therapy. Unfortunately these processes are also a cause of achlorhydria.
• Autoimmune causes: Low doses of corticosteroids. Corticosteroids may be particularly effective in achlorhydria accompanied by eosinophilic gastroenteritis.
• Vitamin deficiencies and pernicious anemia: Nutritional supplements (esp. vitamin B12 [15]), and thiamine.

Potential outcomes and complications of the disease have not yet been fully investigated. Nevertheless, achlorhydria is considered to be a precancerous stage, as the risk of malignancy is high.

An interesting fact is that a gastric environment of normal pH value only renders it possible for bacteria of the helicobacter species to grow, a stomach with a pH >4 also allows for the development of other, non-helicobacter species. There have been experiments proving that non-helicobacter bacteria can also cause atrophic gastritis and subsequent gastric carcinoma [4]. 

Hydrochloric acid is produced by the gastric lining, specifically from the parietal cells and has two functions which are vital for the digestion of food. It converts pepsinogen into pepsin and together with other chemical elements (enzymes), it is responsible for digestion. The absence or very low concentration of hydrochloric acid leads to problems with normal digestion, since its function cannot be carried out by the other enzymes alone, even pepsin needs an acidic intragastric pH in order to function.

There are many conditions leading to achlorhydria:

• Gastric neoplasms: A cancerous tumor of or adjacent to the regions where HCl is produced is one of the primary causes of achlorhydria. A pancreatic neoplasm (VIPoma) may also cause achlorhydria. 
• H. pylori infection reduces acid production and neutralizes the already existing HCl [2].
• Autoimmune diseases: Antibodies against the parietal cells cause a reduction of gastric acid secretion.
• Surgical processes such as gastric bypass or resection [4].
• Proton-pump inhibitor abuse (PPI), usually to treat gastroesophageal reflux disease [3].
• Radiation therapy of the stomach.

Even though the condition is defined as achlorhydria, in reality it is very unusual and rare for a total absence of gastric acid to be the case. Generally, gastric acid concentration is severely diminished, so that its quantity does not suffice to carry out digestion.

The exact incidence and prevalence of achlorhydria are unknown. Gastric atrophy, however, which corresponds to a concentration of pepsinogen I less than 25 nanograms/mL or pepsinogen I/II ratio less than 3.0, has been calculated by studies to be present in 10-15% of the senior population [5]. It is also a known fact that gastric atrophy is directly linked to intestinal metaplasia and increases the risk of patients for developing a gastric adenocarcinoma, by 2 or 3 times. 16% of patients suffering from dyspepsia have been diagnosed with gastric atrophy, whose incidence fluctuates between 0%-11% per year. An important observation is that patients with an H. pylori infection tend to exhibit gastric atrophy more frequently than those unaffected by the infection [7].

Another autoimmune disease, pernicious anemia, caused by autoimmunity against the parietal cells and/or the intrinsic factor, has been found to be present in just over 2% of the population aged over 60 years old. In a study conducted among the German population, researchers evaluated 9684 patients aged 50-74 years old and used the ELISA technique to detect parietal cell autoantibodies. Antibodies against the hydrogen-potassium-stimulated adenosine triphosphatase (H+/K+ ATPase), the proton pump of the parietal cell, were found in 20% of the participants [6]. Pernicious anemia causes cobalamin deficiency.

As mentioned above, the existence of an H. pylori infection plays a crucial role in the secretion of gastric acid. Even though 50% of the world's population are H. pylori carriers, not everyone exhibits an active infection. In those patients who do exhibit it, the production of gastric acid is considerably diminished and usually, the gastritis caused affects the whole of the stomach (pangastritis). An H. pylori infection produces this effect on the stomach via two mechanisms, the microorganism itself produces toxins that hinder the secretion of HCl from parietal cells and the inflammatory process that accompanies an H. pylori infection further inhibits gastric acid production [1]. For instance, toxins released by H. pylori inhibit the expression of human hydrogen-potassium-stimulated adenosine triphosphatase (H+/K+ ATPase) alpha-subunit and hinder the transport of H+/K+ ATPase-containing tubulovesicles to the apical membrane, both indicate direct damage. On the other hand, interleukin-1beta, tumour necrosis factor-alpha as well as other cytokines, all by-products of the inflammatory process, also damage parietal cells, resulting in a diminished production of gastric acid [1]. A complication of this process is the loss of parietal cells and the oxyntic glands atrophy and from that point and on, achlorhydria is irreversible. A potential explanation for the damage caused to the stomach by a H. pylori infection suggests that this is mediated by autoantibodies against the Lewis x and y blood group antigens, which are expressed both by the microorganism's lipopolysaccharide and the proton pump. These antibodies are believed to result in autoimmune gastritis and the subsequent gastric atrophy [1] [8].

Autoimmune gastritis is also observed in patients affected by other autoimmune diseases, such as autoimmune thyroiditis, vitiligo, Graves disease, diabetes mellitus, idiopathic adrenocortical insufficiency, postpartum thyroiditis, primary biliary cirrhosis and hypoparathyroidism [9] [10]. Autoantibodies against the parietal cell and intrinsic factor are exhibited in 32% and 12% respectively, of patients affected by primary biliary cirrhosis [9].

Surgical interventions such as antrectomy with vagotomy also play an important role in the development of achlorhydria. The process of antrectomy removes gastrin, which stimulates the production of acid and is secreted by antral G cells. It also removes the hormone which controls oxyntic mucosa growth. Vagotomy on the other hand prevents stimulants such as the sight, taste and smell of food from being transmitted to the brain and ultimately perceived. A further reflux of bile into the stomach, a complication of the surgical procedure, deteriorates the problem, contributing to the atrophy and inflammation.

With reference to gastrin, it is the hormone primarily stimulating the production of gastric acid upon the ingestion of food. Antral G cells produce gastrin, which then performs a dual function, it acts directly on the acid-secreting parietal cells and indirectly stimulates histamine production from enterochromaffin-like (ECL) cells. Histamine is released to the region of the nearby parietal cells, binding to histamine H2 receptors and further stimulating the production of gastric acid. After digestion has been completed, somatostatin (SST) gives the signal for the cessation of gastrin production. SST is produced by the antral D cells in response to luminal acid. In cases of achlorhydria, luminal acid does not cause the proper effect on SST, whose production is diminished. As a result, it fails to control the secretion of gastrin (disinhibition) and to perform its task, leading to hypergastrinemia. This mechanism also helps to comprehend the pathway leading from hypergastrinaemia to malignancy. Given that gastrin also induces the growth of the oxyntic mucosa, a failure to restrain its production leads to a continually growing mucosa. If no intervention to correct gastrin levels is performed, ECL cells become hypertrophic. If the phenomenon continues, ECL cells proceed from hyperplasia to dysplasia and, ultimately, to potential cancerous tumors.

There are no specific guidelines as to how an individual can prevent the occurrence of achlorhydria. Following basic hygienic measures does, however, prevent an H. pylori infection in many cases, and following a therapeutic scheme upon such a diagnosis, helps to eradicate the bacterium from the intragastric region. In this way, the danger of atrophic or autoimmune gastritis is diminished. Since achlorhydria is also caused by gastric surgery, its incidence can also be reduced by surgeons avoiding a great number of surgical processes on the stomach, in cases where conservative treatment can be applied.

The simple definition of achlorhydria involves the complete absence of HCl in gastric secretions [1]. Pathophysiologically, it has also been defined in the following ways:

1. As the existence of a maximum acid output in response to an effective stimulus, leading to an intragastric pH> 5.09 (men) and >6.81 (women).
2. As the state which presents with a ratio of serum pepsinogen I/pepsinogen II <2.9.
3. As the existence of a maximum acid output <6.9 m/mole/h (men) and <5.0 m/mole/h (women).

Pathologic and surgical causes of achlorhydria are all described below. In general, this condition is considered a precancerous stage, since it is linked to metaplasia of the gastric mucosa, which can then further result in a dysplastic condition.

Achlorhydria is a clinical condition featuring diminished or absent production of acidic fluid in the stomach. It is linked with multiple medical conditions.

Causes

Achlorhydria is caused by many types of conditions, some of which include:

• Hypothyroidism which is responsible for the the slowdown of metabolism
• Autoimmune diseases which produce antibodies against the stomach cells that produce acid
• Drugs or antacids which lower the secretion of acid or its transportation
• Atrophic gastritis, pernicious anemia or stomach cancer
• Helicobacter pylori infection, where the bacteria damage acid producing cells in order to maintain a less acidic pH to aid their survival
• Stomach radiation therapy
• Gastric surgical procedures (Roux-en-Y, duodenal stitch etc). These procedures lead to the incapacitation of gastric regions that produce acids. 
• Niacin deficiency (pellagra)
• Pancreatic tumors (somatostatinomas, VIPomas) or vasoactive intestinal peptides
• Other rare disorders like mucolipidosis (IV type)

Symptoms

The clinical manifestation of achlorhydria includes:

• Abdominal bloating and early satiety
• Diminished levels of acidic fluid in the stomach
• Indigestion

Achlorhydria causes symptoms that closely resemble those of gastroesophagel reflux disease, even though the mechanisms involved in the two conditions are completely distinct. A crucial complication of achlorhydria involves the potential overgrowth of bacteria in the stomach, such as the vibrio vulnificus, which is found in seafood. Prolific amounts of bacteria in the stomach may lead to diarrhoic phenomena or vitamin/nutient deficiency, including zinc, magnesium, B,C and K complex vitamins; these conditions may further lead to multiple pathologies, ranging from neuromuscular disorders to fatal diseases. In cases of achlorhydria, food is not digested successfully by the responsible enzymes, a state which causes pain, bloating and a great amount of discomfort after consuming food.

Diagnosis 

Achlorhydria is diagnosed after the evaluation of stomach pH value, levels that are greater than 4.0 even after stimulation with pentagastrin are typical of achlorhydria. Gastrin levels in the blood are also a common finding. Lastly, almost 90% of patients with achlorhydria are found to have antibodies against the  H+/K+ ATP-ase proton pump.

Treatment

The most successful way of treating achlorhydria is by eradicating its initial cause, as described before. Apart from the different types of intervention depending on its causes, many doctors also prescribe Betaine HCL/Betaine hydrochloride, in order to increase the gastric acids and facilitate proper digestion. Betaine HCL contains chloride, which releases hydrochloric acid in the stomach, partially compensating for the reduced amount of acidic fluids that the stomach itself can naturally produce. It is sold as a preparation containing pepsin, an enzyme partaking in the digestion process.

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