Achlorhydria: Symptoms, Causes, and Diagnostic Tests

Achlorhydria occurs when there’s an absence of hydrochloric (HCl) acids in the stomach. It’s a more severe form of a hypochlorhydria, a deficiency of stomach acids. Both conditions can impair the digestive process and lead to damage of the gastrointestinal system. Without stomach acid, your body won’t properly break down protein. You’ll also be more susceptible to gastrointestinal infections.

HCl acids break down our food and activate digestive enzymes that dissolve proteins and other nutrients. It also helps kill bacteria, viruses, and parasites in the stomach, protecting you from infection and disease. Left untreated, achlorhydria and hypochlorhydria can have life-threatening consequences.

Symptoms of achlorhydria

Achlorhydria can increase your risk of developing iron deficiency anemia. Without stomach acids, the body will have issues absorbing iron. Other vitamins and minerals such a calcium, folic acid, vitamin C, and vitamin D also rely on adequate stomach acid for their absorption into the digestive tract.

If diagnosed with achlorhydria, doctors often check for anemia. Other achlorhydria symptoms can include:

• abdominal bloating
• indigestion
• nausea
• acid reflux
• digestive issues
• diarrhea
• weak, brittle nails
• hair loss
• undigested food in stools

Without adequate stomach acid, bacterial overgrowth of the small intestine can occur. Achlorhydria complications can also lead to malabsorption, a condition that prevents your small intestine from absorbing nutrients from foods.

Nutrient deficiencies can lead to a variety of problems including neurological issues such as:

• arm and leg weakness
• tingling or numbness in fingers and toes memory
• loss changes in vision
• hallucinations

Causes and risk factors of achlorhydria

Achlorhydria can occur in men and women of all races and ages. However, this condition occurs more frequently in the elderly community. There are a number of factors that can contribute to developing achlorhydria, including:

• Hypothyroidism. This condition can significantly slow down your metabolism, resulting in a decrease of gastric acid production.
• Medications. Antacids are a useful solution to heartburn and indigestion. Proton pump inhibitors (PPIs) can alleviate symptoms from gastroesophageal reflux disease (GERD). Both medications reduce acidity in the stomach. Overuse or complications can prevent the body from producing stomach acids at all, leading to achlorhydria.
• Surgery. Weight loss surgeries, such as the gastric bypass procedure, reduce the size of your stomach and alter how your body handles food. When the function of a significant portion of the stomach is changed, stomach acid production can decrease.
• H. pylori infection. Helicobacter pylori (H. pylori) infection is a condition that causes peptic ulcers. Left untreated, this infection can reduce the amount of stomach acid produced.
• Autoimmune disorders. Certain autoimmune disorders can affect stomach acid production.

Diagnosing achlorhydria

In order to diagnose achlorhydria, doctors will take note of your medical history and current symptoms. They may choose to test the pH of your stomach if you have a history of exhibiting the following symptoms:

• acid reflux
• abdominal pain and bloating
• increased bowel movements
• digestive issues
• weight loss
• signs or symptoms of poor nutrition

Stomach secretions should normally have a pH of around 1.5, which is highly acidic. However, premature infants and the elderly are both noted to have much less acid in their stomachs than that.

If your doctor thinks you might have achlorhydria or hypochlorhydria, a specialist will help determine the best way to measure your stomach acid levels. Blood tests, such as a complete blood count (CBC), can also be used to check for certain types of anemia, which may be related to inadequate stomach acid levels.