Achlorhydria Clinical Presentation

Updated: Mar 05, 2019
  • Author: Divyanshoo Rai Kohli, MD; Chief Editor: BS Anand, MD  more...
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Obtain an appropriate history in patients suspected of having achlorhydria. Elicit risk factors for achlorhydria, including prior gastric bypass surgery, history of chronic H pylori infection, chronic PPI use, and autoimmune conditions (eg, diabetes, autoimmune thyroid disease).

Irrespective of the cause, achlorhydria can result in complications such as bacterial overgrowth, intestinal metaplasia, and hip fracture. Therefore, a history of abdominal discomfort, early satiety, weight loss, bowel movement frequency, reflux symptoms, and abdominal bloating should be taken. Since acidic pH facilitates the absorption of iron, achlorhydric patients often develop iron deficiency anemia. [16] Therefore, patients should be assessed for symptoms of anemia.

Bacterial overgrowth can cause micronutrient deficiencies that result in various clinical neurological manifestations. A complete neurological history, including history of visual changes, paresthesias, ataxia, limb weakness, gait disturbance, memory defects, hallucinations, and personality and mood changes, should also be obtained.

Physical examination

Achlorhydria is not associated with any characteristic physical findings.