1,780 results match your criteria Achlorhydria


Iron deficiency workup reveals high incidence of autoimmune gastritis with parietal cell antibody as reliable screening test.

Semin Hematol 2018 Oct 7;55(4):256-261. Epub 2018 Aug 7.

Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria; Loha for life, Center of Excellence for Iron Deficiency, Vienna, Austria. Electronic address:

Iron deficiency (ID) workup is a common challenge for gastrointestinal endoscopy. In premenopausal women current guidelines recommend serologic evaluation of coeliac disease only. Here we systematically tested serologic screening for autoimmune gastritis (AIG) in a large cohort of patients with ID. Read More

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October 2018
2 Reads

Octreotide reverses shock due to vasoactive intestinal peptide-secreting adrenal pheochromocytoma: A case report and review of literature.

World J Clin Cases 2018 Nov;6(14):862-868

Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

Vasoactive intestinal peptide-producing tumors (VIPoma) usually originate in the pancreas and are characterized by diarrhea, hypokalemia, and achlorhydria (WDHA syndrome). In adults, nonpancreatic VIPoma is very rare. Herein, we report an unusual case of VIP-producing pheochromocytoma marked by persistent shock, flushing, and watery diarrhea and high sensitivity to octreotide. Read More

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November 2018
1 Read

Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis: a prospective study.

BMC Gastroenterol 2018 Nov 8;18(1):172. Epub 2018 Nov 8.

Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Background: Chronic autoimmune atrophic gastritis (CAAG) is an autoimmune disease characterized by hypo/achlorhydria. A role of CAAG in the pathogenesis of nutritional deficiencies has been reported, therefore we hypothesized a possible association between CAAG and 25-OH-Vitamin D [25(OH)D] deficiency. Aim of the present study is to evaluate the prevalence of 25(OH)D deficiency in CAAG patients. Read More

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November 2018
3 Reads

Pancreatic VIPomas from China: Case reports and literature review.

Pancreatology 2018 Oct 26. Epub 2018 Oct 26.

Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Vasoactive intestinal polypeptide-secreting tumors (VIPomas) are rare neuroendocrine tumors that often present as watery diarrhea, hypokalemia, and achlorhydria or hypochlorhydria. In this study, we present our institutional experience of diagnosis and treatment of VIPomas, along with a review of the Chinese literature since 1980. Patient #1, diagnosed in 1984 and with intact clinical records, shows the natural history of this disease. Read More

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October 2018
3 Reads

Conventional Treatment of Hypoparathyroidism.

Endocrinol Metab Clin North Am 2018 12;47(4):889-900

Endocrine Research Unit, Department of Medicine, San Francisco Department of Veterans Affairs Medical Center, University of California, San Francisco, 111N, 1700 Owens Street, 3rd Floor Room 369, San Francisco, CA 94158, USA. Electronic address:

Conventional therapy of hypoparathyroidism consists of oral calcium and either activated vitamin D or vitamin D supplements at varying doses. Although adjusting dosing of calcium and/or activated vitamin D or vitamin D itself, the serum calcium should be obtained weekly or monthly depending on the clinical situation. Calcium supplementation in hypoparathyroidism usually consists of calcium carbonate because it is 40% elemental calcium by weight. Read More

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December 2018
1 Read

Chronic Atrophic Gastritis: A Review.

J Environ Pathol Toxicol Oncol 2018 ;37(3):241-259

Department of Gastrointestinal Colorectal, and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

Chronic atrophic gastritis is a generally asymptomatic condition of great importance because it develops into gastric cancer in a number of patients. It is described as an atrophy of the gastric mucosa. There are two types of atrophic gastritis: a gastric body predominant type in patients with infection of Helicobacter pylori, and an autoimmune type, limited to the gastric body and fundus. Read More

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October 2018
11 Reads

Physiologically based pharmacokinetic modelling to guide drug delivery in older people.

Adv Drug Deliv Rev 2018 Oct 4;135:85-96. Epub 2018 Sep 4.

Simcyp Ltd (a Certara company), Blades Enterprise Centre, John Street, Sheffield, UK; Centre for Applied Pharmacokinetic Research (CAPKR), University of Manchester, Manchester, UK.

Older patients are generally not included in Phase 1 clinical trials despite being the population group who use the largest number of prescription medicines. Physiologically based pharmacokinetic (PBPK) modelling provides an understanding of the absorption and disposition of drugs in older patients. In this review, PBPK models used for the prediction of absorption and exposure of drugs after parenteral, oral and transdermal administration are discussed. Read More

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October 2018
1 Read
15.040 Impact Factor

Mucolipidosis type IV in a child.

J AAPOS 2018 Dec 16;22(6):469-471. Epub 2018 Aug 16.

Department of Ophthalmology, Centre hospitalier universitaire Sainte-Justine, Montréal. Electronic address:

Mucolipidosis type IV is a rare autosomal recessive lysosomal storage disorder with psychomotor developmental delay, visual impairment, and achlorhydria. A mutation in the MCOLN1 gene causes an alteration of the protein mucolipin-1 that results in the accumulation of lipids and proteins in cytoplasmic vacuoles derived from lysosomes. Visual impairment results mainly from corneal clouding and retinal degeneration. Read More

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December 2018
9 Reads

Diagnostic accuracy of a pH stick, modified to detect gastric lipase, to confirm the correct placement of nasogastric tubes.

BMJ Open Gastroenterol 2018 31;5(1):e000218. Epub 2018 Jul 31.

Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Objective: The correct placement of a nasogastric feeding tube is usually confirmed by establishing that an aspirate is acidic using a pH stick. However, antacid medication and achlorhydria can cause false negative pH tests that may delay feeding and increase resource use. The purpose of this study was to evaluate a modified pH stick designed to detect gastric lipase and therefore reduce false negative tests. Read More

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July 2018
10 Reads

High incidence of autoimmune gastritis in patients misdiagnosed with two or more failures of H. pylori eradication.

Aliment Pharmacol Ther 2018 Aug 19;48(3):370-377. Epub 2018 Jun 19.

First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.

Background: Although autoimmune gastritis (AIG) is generally considered relatively rare, we frequently encounter AIG among patients at to our hospital who have experienced at least two episodes of Helicobacter pylori eradication failure.

Aims: We investigated the incidence of AIG in consecutive patients who consulted our department for H. pylori eradication with reference to eradication history. Read More

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August 2018
5 Reads

A case of Metaplastic atrophic gastritis in immune Dysregulation, Polyendocrinopathy, Enteropathy, X-linked (IPEX) syndrome.

BMC Pediatr 2018 Jun 15;18(1):191. Epub 2018 Jun 15.

Gastroenterology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background: Autoimmune metaplastic atrophic gastritis is a chronic progressive inflammatory condition. The clinical spectrum includes pernicious anemia, atrophic gastritis, antibodies to parietal cell antigens and intrinsic factor, achlorhydria, hypergastrinemia and carcinoma. It is rare in paediatric cohorts. Read More

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June 2018
14 Reads

Physiologically Based Absorption Modeling of Salts of Weak Bases Based on Data in Hypochlorhydric and Achlorhydric Biorelevant Media.

AAPS PharmSciTech 2018 Jun 5. Epub 2018 Jun 5.

Department of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, 15784, Zografou, Greece.

Physiologically based absorption modeling has been attracting increased attention to study the interactions of weakly basic drug compounds with acid-reducing agents like proton-pump inhibitors and H2 blockers. Recently, standardized gastric and intestinal biorelevant media to simulate the achlorhydric and hypochlorhydric stomach were proposed and solubility and dissolution data for two model compounds were generated. In the current manuscript, for the first time, we report the utility of these recently proposed biorelevant media as input into physiologically based absorption modeling. Read More

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June 2018
29 Reads

Amorphous solid dispersions of carvedilol along with pH-modifiers improved pharmacokinetic properties under hypochlorhydoria.

Biopharm Drug Dispos 2018 Apr;39(4):232-242

Department of Pharmacokinetics and Pharmacodynamics, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan.

Carvedilol (CAR) belongs to biopharmaceutics classification system class-II drugs, with poor aqueous solubility and pH-dependent solubility. The present study aimed to develop a novel amorphous solid dispersion (ASD) of CAR with acidic counter ions for pH modifications in microenvironment to improve the pharmacokinetic properties under hypochlorhydric conditions. CAR-ASD was prepared by freeze-drying in combination with counter ions and hydroxypropyl cellulose, and their physicochemical properties including dissolution behavior, storage stability, and photostability were characterized. Read More

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April 2018
3 Reads

HIGH-RISK GASTRIC PATHOLOGY AND PREVALENT AUTOIMMUNE DISEASES IN PATIENTS WITH PERNICIOUS ANEMIA.

Endocr Pract 2017 Nov;23(11):1297-1303

Objective: Pernicious anemia (PA) develops from atrophic gastritis due to autoimmune destruction of parietal cells and results in achlorhydria, vitamin B12 and iron deficiencies, anemia, neurologic deficits, and premalignant and malignant stomach lesions. We report the presentation, diagnosis and gastric complications of PA in patients from an endocrinology practice.

Methods: Thirty-four patients (31 female, 3 male) with PA who underwent esophagogastroduodenoscopy (EGD) or gastrectomy were identified. Read More

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November 2017
22 Reads

The risk of infection in patients with pernicious anaemia: a retrospective cohort study using primary care database.

United European Gastroenterol J 2017 Nov 21;5(7):959-966. Epub 2017 Feb 21.

Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.

Background: Studies have found an association between proton pump inhibitor (PPI) use and infection. The purpose of this study was to determine whether the mechanism by which PPIs induce an increased risk of infection is supported by the same mechanism acting in another cause of achlorhydria, pernicious anaemia.

Methods: Using a database of anonymised primary care records between 1990 and 2013, we selected exposed patients with a diagnosis of pernicious anaemia treated with vitamin B12 therapy. Read More

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November 2017
21 Reads

Comparison of the human gastric microbiota in hypochlorhydric states arising as a result of Helicobacter pylori-induced atrophic gastritis, autoimmune atrophic gastritis and proton pump inhibitor use.

PLoS Pathog 2017 Nov 2;13(11):e1006653. Epub 2017 Nov 2.

Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UNITED KINGDOM.

Several conditions associated with reduced gastric acid secretion confer an altered risk of developing a gastric malignancy. Helicobacter pylori-induced atrophic gastritis predisposes to gastric adenocarcinoma, autoimmune atrophic gastritis is a precursor of type I gastric neuroendocrine tumours, whereas proton pump inhibitor (PPI) use does not affect stomach cancer risk. We hypothesised that each of these conditions was associated with specific alterations in the gastric microbiota and that this influenced subsequent tumour risk. Read More

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November 2017
18 Reads

High prevalence of gastric intestinal metaplasia detected by confocal laser endomicroscopy in Zambian adults.

PLoS One 2017 8;12(9):e0184272. Epub 2017 Sep 8.

Tropical Gastroenterology & Nutrition group, Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.

Background: Confocal laser endomicroscopy (CLE) may increase the detection of gastric premalignant lesions, and facilitate targeted biopsies for histology. The study aim was to analyse premalignant lesions in Zambian adults using CLE.

Methods: Using CLE and histology we analysed the antral mucosa for gastric premalignant lesions in asymptomatic adults living with HIV and in HIV seronegative adults. Read More

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October 2017
15 Reads

Biorelevant Dissolution Models for a Weak Base To Facilitate Formulation Development and Overcome Reduced Bioavailability Caused by Hypochlordyria or Achlorhydria.

Mol Pharm 2017 10 8;14(10):3577-3587. Epub 2017 Sep 8.

Pfizer Korea, Pfizer Tower, 110, Toegye-ro, Jung-gu, Seoul 04631, Korea.

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 and achlorhydric patients. The dissolution models were designed to approximate the hypo-/achlorhydric and normal fasted stomach conditions after a glass of water was ingested with the drug. The dissolution data from the two models were predictive of the relative in vivo bioavailability of various formulations under the same gastric condition, hypo-/achlorhydric or normal. Read More

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October 2017
27 Reads

Virtual bioequivalence for achlorhydric subjects: The use of PBPK modelling to assess the formulation-dependent effect of achlorhydria.

Eur J Pharm Sci 2017 Nov 1;109:111-120. Epub 2017 Aug 1.

Centre for Applied Pharmacokinetic Research, Division of Pharmacy & Optometry, University of Manchester, Manchester, UK; Simcyp Limited (A Certara Company), Sheffield, UK.

Majority of bioequivalence studies are conducted in healthy volunteers. It has been argued that bioequivalence may not necessarily hold true in relevant patient populations due to a variety of reasons which affect one formulation more than the other for instance in achlorhydric patients where elevated gastric pH may lead to differential effects on formulations which are pH-sensitive with respect to release or dissolution. We therefore examined achlorhydria-related disparity in bioequivalence of levothyroxine and nifedipine formulations using virtual bioequivalence within a physiologically-based pharmacokinetic (PBPK) modelling framework. Read More

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November 2017
27 Reads

A Case of Severe Iron Deficiency Anemia Associated with Long-Term Proton Pump Inhibitor Use.

Curr Ther Res Clin Exp 2017 21;84:1-3. Epub 2017 Jan 21.

Department of Internal Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.

The use of proton pump inhibitors (PPIs) in the treatment of gastrointestinal diseases has evolved over recent years. Initially intended for short-term use, PPIs are increasingly being used, often inappropriately, as long-term maintenance medications. The mechanism of action of PPIs is suppression of gastric basal and stimulated acid secretion by inhibiting the parietal cell H/K ATP pump with a resultant increase in gastric pH and hypo- or achlorhydria. Read More

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January 2017
19 Reads

Verner-Morrison syndrome. Literature review.

Rom J Morphol Embryol 2017 ;58(2):371-376

Department of Pediatric Surgery, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Department of Neonatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania;

Chronic diarrhea in infants is a common condition for addressability to pediatric gastroenterologists. The causes are multiple and the delay in reaching the final diagnosis can lead to complications in the general condition of the child. The purpose of this review is to present the bio-clinical and histogenetic particularities of a rare clinical entity, characterized by tumoral causes of chronic diarrhea. Read More

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April 2018
26 Reads

Hunger and microbiology: is a low gastric acid-induced bacterial overgrowth in the small intestine a contributor to malnutrition in developing countries?

Microb Biotechnol 2017 09 17;10(5):1025-1030. Epub 2017 Jul 17.

Nutrition and Health Institute, Gut Ecosystem Department, Host- Microbe Interaction Group, Nestlé Research Centre, CH-1000, Lausanne 26, Switzerland.

Underproduction of hydrochloric acid into the stomach is frequently encountered in subjects from developing countries. We explore the hypothesis that hypochlorhydria compromises the gastric barrier and favours bacterial overgrowth in the proximal parts of the small intestine where nutrient absorption takes place. Food calories are thus deviated into bacterial metabolism. Read More

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September 2017
12 Reads

TRPML1: The Caretaker of the lysosome.

Cell Calcium 2018 01 24;69:112-121. Epub 2017 Jun 24.

Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078 Pozzuoli ,NA, Italy. Electronic address:

Efficient functioning of lysosome is necessary to ensure the correct performance of a variety of intracellular processes such as degradation of cargoes coming from the endocytic and autophagic pathways, recycling of organelles, and signaling mechanisms involved in cellular adaptation to nutrient availability. Mutations in lysosomal genes lead to more than 50 lysosomal storage disorders (LSDs). Among them, mutations in the gene encoding TRPML1 (MCOLN1) cause Mucolipidosis type IV (MLIV), a recessive LSD characterized by neurodegeneration, psychomotor retardation, ophthalmologic defects and achlorhydria. Read More

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January 2018
18 Reads

A cumulative effect involving malfunction of the PTH1R and ATP4A genes explains a familial gastric neuroendocrine tumor with hypothyroidism and arthritis.

Gastric Cancer 2017 Nov 4;20(6):998-1003. Epub 2017 May 4.

Human Genetics Group, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, 28029, Madrid, Spain.

Background: Type I gastric neuroendocrine tumors (gNETs) classically arise because of hypergastrinemia and involve destruction of parietal cells, which are responsible for gastric acid secretion through the ATP4A proton pump and for intrinsic factor production.

Methods: By whole exome sequencing, we studied a family with three members with gNETs plus hypothyroidism and rheumatoid arthritis to uncover their genetic origin.

Results: A heterozygous missense mutation in the ATP4A gene was identified. Read More

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November 2017
28 Reads

Autoimmune gastritis: relationships with anemia and Helicobacter pylori status.

Scand J Gastroenterol 2017 Jun - Jul;52(6-7):674-677. Epub 2017 Feb 17.

h Gastroenterology and Hepatology Section, Department of Medicine , University of Perugia School of Medicine , Perugia , Italy.

Background: Autoimmune gastritis (AIG) is a gastric pathologic condition affecting the mucosa of the fundus and the body and eventually leading to hypo-achlorhydria.

Aims: We report our clinical and pathological experience with AIG.

Methods: Data from patients with a diagnosis of AIG seen in the period January 2002-December 2012 were retrieved. Read More

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October 2017
16 Reads

The impact of reduced gastric acid secretion on dissolution of salts of weak bases in the fasted upper gastrointestinal lumen: Data in biorelevant media and in human aspirates.

Eur J Pharm Biopharm 2017 Jun 16;115:94-101. Epub 2017 Feb 16.

Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Zografou, Greece. Electronic address:

Purpose: To propose media for simulating the intragastric environment under reduced gastric acid secretion in the fasted state at three levels of simulation of the gastric environment and evaluate their usefulness in evaluating the intragastric dissolution of salts of weak bases. To evaluate the importance of bicarbonate buffer in biorelevant in vitro dissolution testing when using Level II biorelevant media simulating the environment in the fasted upper small intestine, regardless of gastric acid secretions.

Methods: Media for simulating the hypochlorhydric and achlorhydric conditions in stomach were proposed using phosphates, maleates and bicarbonates buffers. Read More

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June 2017
23 Reads

Persisting Hypocalcemia After Surgical Parathyroidectomy: The Differential Effectiveness of Calcium Citrate Versus Calcium Carbonate With Acid Suppression.

Am J Med Sci 2017 Jan 22;353(1):82-86. Epub 2016 Apr 22.

Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; FMC Extracorporeal Life Support Center, Fresenius Medical Care of Hungary, University of Debrecen Medical and Health Sciences Center, Debrecen, Hungary. Electronic address:

The effectiveness of oral calcium (Ca) may be contingent on a patient׳s factors beyond compliance, such as proton-pump inhibitor use and the choice of calcium supplements. A 32-year-old Hispanic male with end-stage renal disease on peritoneal dialysis underwent successful surgical parathyroidectomy (intact parathyroid hormone level: 2,328pg/mL; postsurgical: 287-69pg/mL [normal: 8.5-72. Read More

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January 2017
22 Reads

Meal Effects Confound Attempts to Counteract Rabeprazole-Induced Hypochlorhydria Decreases in Atazanavir Absorption.

Pharm Res 2017 03 27;34(3):619-628. Epub 2016 Dec 27.

Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, 533 Parnassus Ave., Room U-68, San Francisco, CA, 94143-0912, USA.

Purpose: Clinically relevant pharmacokinetic interactions exist between gastric acid-reducing agents and certain weakly basic drugs that rely on acidic environments for optimal oral absorption. In this study, we examine whether the administration of betaine hydrochloride under fed conditions can enhance the absorption of atazanavir, an HIV-1 protease inhibitor, during pharmacologically-induced hypochlorhydria.

Methods: In this randomized, single-dose, 3 period, crossover study healthy volunteers received ritonavir-boosted atazanavir (atazanavir/ritonavir 300/100 mg) alone, following pretreatment with the proton pump inhibitor rabeprazole (20 mg twice daily), and with 1500 mg of betaine HCl after rabeprazole pretreatment. Read More

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March 2017
19 Reads

[Subtype classification and clinicopathological characteristics of gastric neuroendocrine neoplasms: an analysis of 241 cases].

Zhonghua Wei Chang Wai Ke Za Zhi 2016 Nov;19(11):1241-1246

Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China.

Objective: To study subtype classification of gastric neuroendocrine neoplasm (NEN) and their clinicopathological characteristics in order to provide reference for clinical practice.

Methods: Clinicopathological data of 241 gastric NEN patients (174 cases from China-Japan Friendship Hospital and 67 cases from The First Affiliated Hospital of Sun Yat-Sen University) between January 2011 and June 2016 were retrospectively summarized. According to serum gastrin, 24-hour intragastric pH monitoring and pathological grade, patients with gastric NEN were divided into 4 types: type I( (hypergastrinemia and achlorhydria, related to autoimmune chronic atrophic gastritis), type II( [hypergastrinemia and Zollinger-Ellison syndrome, related to gastrinoma or multiple endocrine neoplasia type I( (MEN-I()], type III( (sporadic disease with normal serum gastrin level), and type IIII( [poorly differentiated gastric neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC)]. Read More

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November 2016
50 Reads

Improved oral absorption profile of itraconazole in hypochlorhydria by self-micellizing solid dispersion approach.

Eur J Pharm Sci 2017 Jan 31;97:55-61. Epub 2016 Oct 31.

Department of Pharmacokinetics and Pharmacodynamics, School of Pharmaceutical Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka 422-8526, Japan. Electronic address:

The present study was aimed to evaluate the applicability of a self-micellizing solid dispersion (SMSD) system of itraconazole (ITZ) with the use of Soluplus to achieve improved dissolution and stable oral absorption of ITZ under hypochlorhydric conditions. The SMSD of ITZ (SMSD/ITZ) was prepared by the freeze-drying method. Physicochemical properties of SMSD/ITZ were assessed in terms of morphology, crystallinity, particle size, thermal behavior, dissolution profile, and stability. Read More

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January 2017
30 Reads

Liquid and softgel levothyroxine use in clinical practice: state of the art.

Endocrine 2016 Oct 29;54(1):3-14. Epub 2016 Jul 29.

Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.

Levothyroxine is recognized as the treatment of choice for hypothyroidism. So far, the tablet levothyroxine has been the formulation almost exclusively used, even though an optimal daily dose of levothyroxine has been unsuccessfully sought and a consensus not achieved. Due to progressive use of a more individually tailored levothyroxine dose, increasing evidence has instead displayed that many gastrointestinal disorders, polypharmacy, and food interference may raise the daily levothyroxine requirement. Read More

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October 2016
20 Reads

Netazepide, a gastrin/cholecystokinin-2 receptor antagonist, can eradicate gastric neuroendocrine tumours in patients with autoimmune chronic atrophic gastritis.

Br J Clin Pharmacol 2017 03 21;83(3):466-475. Epub 2016 Nov 21.

Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool, L69 3GE, UK.

Aims: Netazepide, a gastrin/cholecystokinin 2 receptor antagonist, once daily for 12 weeks reduced the number of tumours and size of the largest one in 16 patients with autoimmune chronic atrophic gastritis (CAG), achlorhydria, hypergastrinaemia and multiple gastric neuroendocrine tumours (type 1 gastric NETs), and normalized circulating chromogranin A (CgA) produced by enterochromaffin-like cells, the source of the tumours. The aim was to assess whether longer-term netazepide treatment can eradicate type 1 gastric NETs.

Methods: After a mean 14 months off netazepide, 13 of the 16 patients took it for another 52 weeks. Read More

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March 2017
17 Reads

Primary Pancreatic Secretinoma: Further Evidence Supporting Secretin as a Diarrheogenic Hormone.

Ann Surg 2017 08;266(2):346-352

*Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH †Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH ‡Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies, Comprehensive Wound Center, Laser Capture Molecular Core, The Ohio State University Wexner Medical Center, Columbus, OH §Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI ¶Department of Surgery, University of California at Los Angeles, School of Medicine, Los Angeles, CA ||Department of Surgery, Florida State University, Tallahassee, FL **William and Sheila Konar Center for Digestive and Liver Diseases, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY.

Objectives: To document the existence of primary pancreatic secretinoma in patients with watery diarrhea syndrome (WDS) and achlorhydria and establish secretin as a diarrheogenic hormone.

Background: Vasoactive intestinal peptide (VIP) has been widely accepted as the main mediator of WDS. However, in 1968, Zollinger et al reported 2 female patients with pancreatic neuroendocrine tumors, WDS, and achlorhydria. Read More

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August 2017
20 Reads

A knockin mouse model for human ATP4aR703C mutation identified in familial gastric neuroendocrine tumors recapitulates the premalignant condition of the human disease and suggests new therapeutic strategies.

Dis Model Mech 2016 09 4;9(9):975-84. Epub 2016 Aug 4.

Human Genetics Group, Spanish National Cancer Research Center (CNIO), Madrid 28029, Spain Spanish Center for Biomedical Network Research on Rare Diseases (CIBERER), Madrid 28029, Spain

By whole exome sequencing, we recently identified a missense mutation (p.R703C) in the human ATP4a gene, which encodes the proton pump responsible for gastric acidification. This mutation causes an aggressive familial type I gastric neuroendocrine tumor in homozygous individuals. Read More

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September 2016
26 Reads

Poorly Differentiated Neuroendocrine Tumor of the Esophagus with Hypertrophic Osteoarthropathy and Brain Metastasis: A Success Story.

Cureus 2016 Jun 19;8(6):e646. Epub 2016 Jun 19.

Medicine, Tufts Medical Center.

Neuroendocrine carcinomas (NECs) of the esophagus are very rare. The majority of the patients with NECs present with metastasis. Paraneoplastic syndromes, such as syndrome of inappropriate secretion of anti-diuretic hormone and watery diarrhea-hypokalemia-achlorhydria syndrome, have been reported in previous reports. Read More

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June 2016
12 Reads

Hyponatremia, Hypokalemia, Hypochloremia, and Other Abnormalities.

Clin Chem 2016 06;62(6):898

The Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH.

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June 2016
1 Read

Genetic Evolution of a Helicobacter pylori Acid-Sensing Histidine Kinase and Gastric Disease.

J Infect Dis 2016 08 10;214(4):644-8. Epub 2016 May 10.

Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition Department of Cancer Biology, Vanderbilt University School of Medicine.

Helicobacter pylori is the strongest risk factor for gastric adenocarcinoma, which develops within a hypochlorhydric environment. We sequentially isolated H. pylori (strain J99) from a patient who developed corpus-predominant gastritis and hypochlorhydia over a 6-year interval. Read More

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August 2016
15 Reads

Expression of Tlr2, Defa, Muc2 genes in rat duodenal upon long-term gastric hypacidity and with multiprobiotic correction.

Tsitol Genet 2016 May-Jun;50(3):57-65

Expression of Tlr2, Muc2, Defa genes in rat duodenal upon long-term gastric hypacidity (hypochlorhydria) and with multiprobiotic correction was investigated. Increasing of Tlr2, Muc2, Defa expression on the background of the intensification of lipid peroxidation in rat duodenal villus and crypt epithelial cells upon gastric hypoacidity was shown. The mRNAs patterns of genes mentioned above were shown to decrease or approach to control values as well as the level of lipid peroxidation products under the treatment of hypoacidic rats with the multiprobiotic. Read More

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December 2018

Kcne2 deletion causes early-onset nonalcoholic fatty liver disease via iron deficiency anemia.

Sci Rep 2016 Mar 17;6:23118. Epub 2016 Mar 17.

Bioelectricity Laboratory, Dept. of Pharmacology and Dept. of Physiology and Biophysics, School of Medicine, University of California, Irvine, CA, USA.

Nonalcoholic fatty liver disease (NAFLD) is an increasing health problem worldwide, with genetic, epigenetic, and environmental components. Here, we describe the first example of NAFLD caused by genetic disruption of a mammalian potassium channel subunit. Mice with germline deletion of the KCNE2 potassium channel β subunit exhibited NAFLD as early as postnatal day 7. Read More

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March 2016
22 Reads

Characteristics of the Human Upper Gastrointestinal Contents in the Fasted State Under Hypo- and A-chlorhydric Gastric Conditions Under Conditions of Typical Drug - Drug Interaction Studies.

Pharm Res 2016 06 14;33(6):1399-412. Epub 2016 Mar 14.

Faculty of Pharmacy, School of Health Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 157 71, Zografou, Greece.

Objective: Evaluate the impact of reduced gastric acid secretion after administration of two acid-reducing agents on the physicochemical characteristics of contents of upper gastrointestinal lumen of fasted adults.

Materials And Methods: Eight healthy male adults, fasted from food for 12 h, participated in a three-phase crossover study. Phase 1: No drug treatment prior to aspirations. Read More

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June 2016
16 Reads

Hypochlorhydria-induced calcium malabsorption does not affect fracture healing but increases post-traumatic bone loss in the intact skeleton.

J Orthop Res 2016 11 14;34(11):1914-1921. Epub 2016 Mar 14.

Institute of Orthopedic Research and Biomechanics, University Medical Center Ulm, Helmholtzstraße 14, Ulm, 89081, Germany.

Efficient calcium absorption is essential for skeletal health. Patients with impaired gastric acidification display low bone mass and increased fracture risk because calcium absorption is dependent on gastric pH. We investigated fracture healing and post-traumatic bone turnover in mice deficient in Cckbr, encoding a gastrin receptor that affects acid secretion by parietal cells. Read More

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November 2016
25 Reads

Osteoporosis in Gastrointestinal Diseases.

Adv Clin Exp Med 2016 Jan-Feb;25(1):185-90

Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poland.

Secondary osteoporosis occurs as an isolated pathology or co-exists with types I and II osteoporosis. The gastroenterologist may come across osteoporosis or osteopenia in a patient with a gastrointestinal disease. This is often a young patient in whom investigations should be carried out and appropriate treatment initiated, aimed at preventing bone fractures and the formation of the best peak bone mass. Read More

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June 2016
14 Reads

Association of autoimmune thyroid diseases, chronic atrophic gastritis and gastric carcinoid: experience from a single institution.

J Endocrinol Invest 2016 Jul 29;39(7):779-84. Epub 2016 Feb 29.

Endocrinology, Garibaldi-Nesima Hospital, Via Palermo n. 636, 95126, Catania, Italy.

Purpose: Autoimmune polyendocrine syndromes (APS) type III are characterized by the association of autoimmune thyroid disease (ATD) with other autoimmune diseases such as diabetes, alopecia, pernicious anemia, vitiligo and chronic atrophic gastritis. A strong association between ATD and atrophic gastritis (AG) has been demonstrated. Moreover 10 % of patients affected by AG have a predisposition to develop gastric carcinoid and adenocarcinoma as a result of chronic hypergastrinemia caused by achlorhydria and subsequent ELC cells neoplastic transformation. Read More

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July 2016
17 Reads

Impaired skeletal health in patients with chronic atrophic gastritis.

Scand J Gastroenterol 2016 Jul 8;51(7):774-81. Epub 2016 Feb 8.

a Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway ;

Objective: In chronic atrophic gastritis (CAG), destruction of gastric parietal cells causes anacidity and hypergastrinemia. Use of proton pump inhibitors, which also induces gastric anacidity, is associated with increased fracture rates. Our objectives were to study possible differences in bone mineral density (BMD) and bone quality in patients with CAG compared to controls. Read More

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July 2016
21 Reads

Reply to R Schiffmann.

Am J Clin Nutr 2015 Dec;102(6):1615-6

From the Department of Internal Medicine, Baylor University Medical Center, Dallas, TX (e-mail:

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December 2015
13 Reads

A genetic form of achlorhydria and gastritis.

Am J Clin Nutr 2015 Dec;102(6):1615

From the Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX (e-mail:

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December 2015
14 Reads

[Iron deficiency and pernicious anemia: a rare association?].

Ann Biol Clin (Paris) 2015 Jul-Aug;73(4):420-6

Département de médecine interne, CHRU Strasbourg, France.

The aim of this study was to determine the prevalence of iron deficiency among patients with pernicious anemia. We realized a retrospective study from 2000 to 2010 including 55 patients suffering from pernicious anemia who were followed in Reims and Strasbourg university hospitals. Inclusion criteria were histological diagnosis of immune atrophic fundic gastritis and criteria of gastric autoimmuninty, and for which ferritin was measured. Read More

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June 2016
13 Reads