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Front Cell Infect Microbiol 2022 19;12:854904. Epub 2022 Apr 19.

Department of Translational and Precision Medicine, University of Rome "Sapienza", Rome, Italy.

In recent years, the role of gastric and duodenal microbiota has acquired increasing importance in the homeostasis of the host, although, to date, most evidence concern the faecal microbiota. Indeed, the gastric, and duodenal microbiota are challenging to study, due to gastric acid, bile, digestive enzymes, and rapid transit time. Specifically, the gastric acid environment may influence their bacterial composition since the acid barrier protects against orally ingested microorganisms and leads to their inactivation before reaching the intestine. Read More

Food Chem 2022 Jul 16;383:132465. Epub 2022 Feb 16.

College of Food Science and Technology, Nanjing Agricultural University, Key Laboratory of Meat Products Processing, Ministry of Agriculture, Jiangsu Collaborative Innovation Center of Meat Production and Processing, Quality and Safety Control, Nanjing 210095, PR China. Electronic address:

Among the physiological functions declining with aging, decreased secretion of gastric fluid, achlorhydria, is commonly observed. We evaluated the digestion of meat (chicken, beef, and pork) and soy proteins using in vitro conditions mimicking gastrointestinal (GI) digestion in adults (control, C) and elderly individuals with achlorhydria (EA). Changes in degrees of hydrolysis (DH), SDS-PAGE profiles, peptide concentrations, and proteomic profiles during digestion were investigated. Read More

Intern Med 2022 Feb 1. Epub 2022 Feb 1.

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan.

A 69-year-old woman with multiple neuroendocrine neoplasms (NENs) was referred to our hospital. Although she had extreme hypergastrinemia (11,675 pg/mL), no findings that indicated types I to III gastric NENs were found. Although gastric corpus atrophy was suspected on conventional white-light imaging, findings on magnifying endoscopy with narrow-band imaging indicated no severe atrophy. Read More

Cells 2021 12 10;10(12). Epub 2021 Dec 10.

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

Autoimmune polyendocrine syndrome (APS) is assumed to involve an immune system malfunction and entails several autoimmune diseases co-occurring in different tissues of the same patient; however, they are orphans of its accurate diagnosis, as its genetic basis and pathogenic mechanism are not understood. Our previous studies uncovered alterations in the ATPase H+/K+ Transporting Subunit Alpha (ATP4A) proton pump that triggered an internal cell acid-base imbalance, offering an autoimmune scenario for atrophic gastritis and gastric neuroendocrine tumors with secondary autoimmune pathologies. Here, we propose the genetic exploration of APS involving gastric disease to understand the underlying pathogenic mechanism of the polyautoimmune scenario. Read More

World J Gastroenterol 2021 Nov;27(41):7100-7112

Department of Biochemistry, Comenius University, Bratislava 842 15, Slovakia.

Reliable diagnostics are a major challenge for the detection and treatment of () infection. Currently at the forefront are non-invasive urea breath test (UBT) and stool antigen test (SAT). Polymerase chain reaction (PCR) is not endorsed due to nonspecific primers and the threat of false-positives. Read More

AACE Clin Case Rep 2021 Sep-Oct;7(5):323-326. Epub 2021 Apr 16.

Division of Endocrinology, Metabolism, and Lipids, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia.

Objective: Calcium is an essential mineral involved in the functioning of nearly every human cell. Calcium levels are regulated by dietary absorption, vitamin D status, and parathyroid hormone (PTH). This report describes a patient in whom childhood bowel resection and partial gastrectomy resulted in malabsorptive hypocalcemia in adulthood. Read More

PLoS One 2021 27;16(8):e0256487. Epub 2021 Aug 27.

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

Background: Hypochlorhydria (gastric pH >4) increases susceptibility to diarrhoea, iron deficiency, and gastric cancer. We sought to clarify the prevalence of this condition and its predisposing factors in Zambia by pooling data from previous studies conducted in hospital and community settings.

Methods: Gastric pH was measured in participants from five separate studies by collecting gastric aspirate from fasted adults and children under 3 years of age undergoing gastroscopy. Read More

J Med Cases 2021 May 5;12(5):195-201. Epub 2021 Mar 5.

Pediatric Critical Care, University Hospital Fundacion Santa Fe de Bogota, Bogota, Columbia.

Chronic diarrhea is a common chief complaint in the pediatric population with a wide range of diagnostic differentials; as such, whilst suspecting common causes, less prevalent conditions tend to be overlooked, such as neuroendocrine tumor pathologies. VIPomas are characterized by hypersecretion of the vasoactive intestinal peptide (VIP), causing watery diarrhea, hypokalemia, and achlorhydria. Nonetheless, its low incidence rate in children makes it an easily unnoticed pathology. Read More

Mol Pharm 2021 09 24;18(9):3326-3341. Epub 2021 Aug 24.

Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, Michigan 48109, United States.

Orally dosed drugs must dissolve in the gastrointestinal (GI) tract before being absorbed through the epithelial cell membrane. drug dissolution depends on the GI tract's physiological conditions such as pH, residence time, luminal buffers, intestinal motility, and transit and drug properties under fed and fasting conditions (Paixão, P. and Bermejo, M. Read More

Case Rep Hematol 2021 31;2021:9571072. Epub 2021 Jul 31.

Department of Hematology and Oncology, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune Township, NJ, USA.

Vitamin B12 is an essential nutrient which plays an important role in neurological function, hematopoiesis, and DNA synthesis. Low levels usually stem from either poor intake or a malabsorptive process. Presently, the most common cause of vitamin B12 deficiency is food-bound cobalamin malabsorption, which occurs when there is impaired release of vitamin B12 from ingested food due to an outstanding factor preventing the release of the nutrient from its transport protein. Read More

Arch Pathol Lab Med 2022 03;146(3):366-371

From the Departments of Pathology and Immunology (Rais, Chatterjee), Washington University in St. Louis, St. Louis, Missouri.

Context.—: Hypergastrinemia states such as achlorhydria from gastric mucosal atrophy or a gastrin-producing tumor in humans have been associated with the development of enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumors (GNETs). Whether drugs that can elevate serum gastrin levels, such as proton pump inhibitors (PPIs), can produce the same tissue effect is not known, and there is no concrete evidence linking the use of PPIs to GNETs outside animal models and case reports. Read More

Am J Clin Nutr 2021 10;114(4):1286-1294

Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom.

Background: Atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods. The crystalline vitamin B-12 form, found in fortified foods, does not require gastric acid for its absorption and could thus be beneficial for older adults with hypochlorhydria, but evidence is lacking.

Objectives: To investigate associations of AG and PPI use with vitamin B-12 status, and the potential protective role of fortified foods, in older adults. Read More

Dig Liver Dis 2021 Dec 8;53(12):1580-1587. Epub 2021 Jun 8.

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, Rome, Italy. Electronic address:

Background: In corpus atrophic gastritis (CAG), hypochlorhydria makes plausible the overgrowth of intragastric bacteria, whose role in gastric carcinogenesis is under debate.

Aims: To characterize the antrum/corpus composition of the gastric bacterial microbiota in CAG patients compared to controls without CAG.

Methods: A cross-sectional monocentric study on consecutive patients with known histological diagnosis of CAG undergoing gastroscopy for gastric cancer surveillance and patients without CAG undergoing gastroscopy for dyspepsia or anemia (108 biopsies from 55 patients, median age 61. Read More

Pharmaceutics 2021 Apr 28;13(5). Epub 2021 Apr 28.

Kayyali Chair for Pharmaceutical Industries, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.

The study aims to design a novel combination of drug-free solid self-nanoemulsifying drug delivery systems (S-SNEDDS) + solid dispersion (SD) to enhance cinnarizine (CN) dissolution at high pH environment caused by hypochlorhydria/achlorhydria. Drug-loaded and drug-free liquid SNEDDS were solidified using Neusilin US2 at 1:1 and 1:2 ratios. Various CN-SDs were prepared using freeze drying and microwave technologies. Read More

Dysphagia 2022 Apr 27;37(2):350-355. Epub 2021 Apr 27.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Caustic ingestion can lead to structural changes in the upper gastro-intestinal tract. However, there is limited data on the effect of caustic ingestion on gastric secretion. This study was planned to determine changes in gastric acid output after sham feeding in patients with caustic induced esophageal stricture and to compare it with healthy controls. Read More

Front Med (Lausanne) 2021 6;8:553110. Epub 2021 Apr 6.

Human Genetics Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain.

Mutations in the ATP4A proton pump prevent gastric acidification and explain the chronic autoimmune gastritis scenario that conducts the gastric neuroendocrine tumor (gNET) formation. Here, we wanted to investigate the co-occurrence cytomegalovirus (CMV) infection and intestinal inflammation that presented all members of a family affected with gNET and carrying an mutation. Intestinal inflammation persisted after CMV eradication and anemia treatment. Read More

Gastroenterol Res Pract 2021 20;2021:6616334. Epub 2021 Mar 20.

Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Italy.

Background: EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis.

Aims: To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies. Read More

Front Endocrinol (Lausanne) 2021 17;12:652045. Epub 2021 Mar 17.

Centro Ipertensione Arteriosa e Studio Malattie Cardiorenali, S.S. Fisiopatologia Medica, Clinica Medica Generale e Terapia Medica, Parma, Italy.

Background: Pheochromocytoma (PHEO) clinical manifestations generally mirror excessive catecholamines secretion; rarely the clinical picture may reflect secretion of other hormones. Watery diarrhea, hypokalemia and achlorhydria (WDHA) is a rare syndrome related to excessive secretion of vasoactive intestinal peptide (VIP).

Clinical Case: A 73-year-old hypotensive man affected by adrenal PHEO presented with weight loss and watery diarrhea associated with hypokalemia, hyperchloremic metabolic acidosis (anion gap 15 mmol/l) and a negative urinary anion gap. Read More

Wiad Lek 2021 ;74(2):317-320

UKRAINIAN POLTAVA V.G. KOROLENKO NATIONAL PEDAGOGICAL UNIVERSITY, POLTAVA, UKRAINE.

Objective: The aim: Of the study was to study the activity of superoxide dismutase and catalase in the gastric mucosa of rats under long-term administration of omeprazole and combined administration of omeprazole with Symbiter and Apibact multiprobiotics.

Patients And Methods: Materials and methods: The study was carried out on 40 white non-linear male rats with an initial weight of 160-180 g. All animals were divided into 4 groups. Read More

J Gastrointestin Liver Dis 2021 Mar 13;30(1):30-36. Epub 2021 Mar 13.

Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.

Background And Aims: Patients with autoimmune atrophic gastritis (AAG) often complain of acid reflux symptoms, despite the evidence of hypo-achlorhydria. Rome IV criteria are used to define functional esophageal disorders. Our aim was to characterize gastroesophageal reflux disease (GERD) phenotypes in patients with AAG. Read More

Crit Rev Oncog 2020 ;25(4):365-379

Department of Gynecologic Oncology, AdventHealth Cancer Institute, Orlando, FL 32804.

Small intestinal bacterial overgrowth (SIBO) is a common gastrointestinal (GI) problem, but its diagnosis is often missed in the clinical setting. Because its diagnosis mostly requires invasive testing, often its true prevalence is unknown. Commonly presenting complaints include abdominal distension, diarrhea, and malabsorption. Read More

Nutrients 2021 Jan 13;13(1). Epub 2021 Jan 13.

Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy.

Micronutrient deficiencies are relatively common, in particular iron and cobalamin deficiency, and may potentially lead to life-threatening clinical consequences when not promptly recognized and treated, especially in elderly patients. The stomach plays an important role in the homeostasis of some important hematopoietic micronutrients like iron and cobalamin, and probably in others equally important such as ascorbic acid, calcium, and magnesium. A key role is played by the corpus oxyntic mucosa composed of parietal cells whose main function is gastric acid secretion and intrinsic factor production. Read More

Nutr Res 2021 01 18;85:71-83. Epub 2020 Nov 18.

Danone Nutricia Research, Utrecht, The Netherlands; Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.

Retrospective chart reviews have reported hypophosphatemia associated with elemental formula use in infants and children with systemic disease involving multiple diagnoses. The present study aims to evaluate the bioavailability of phosphorus from 2 commercial elemental formulas and to test our hypothesis of bioequivalence of the 2 products in healthy volunteers receiving gastric acid-suppressive medication. A single-center, double-blind, randomized, cross-over study was conducted in healthy volunteers with esomeprazole-induced hypochlorhydria. Read More

Indian J Gastroenterol 2021 02 8;40(1):50-55. Epub 2021 Jan 8.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.

Background: Caustic ingestion can lead to structural changes in the upper gastrointestinal tract. However, there are limited data on the effect of caustic ingestion on gastric secretion. This study was planned to determine the changes in gastric acid output in patients with caustic ingestion. Read More

Adv Nutr 2021 06;12(3):897-903

Blizard Institute, Barts and The London School of Medicine, London, United Kingdom; and Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia.

There is growing awareness that intestinal dysfunction determines the clinical outcomes of situations as diverse as undernourished children in urban tropical slums and undernourished surgical patients in intensive care units. As experimental starvation in humans has only rarely been studied, and largely not using current biomedical research tools, we must draw inference from disparate clinical and experimental observations as to the derangements present in the starved gut. There is good evidence of intestinal atrophy and achlorhydria in starvation and severe undernutrition. Read More

Microorganisms 2020 Nov 19;8(11). Epub 2020 Nov 19.

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, via di Grottarossa 1035, 00189 Rome, Italy.

Autoimmune atrophic gastritis is an organ-specific immune-mediated condition characterized by atrophy of the oxyntic mucosa. Autoimmune atrophic gastritis (AIG) is characterized by a progressive loss of acid-secreting parietal cells leading to hypo-achlorhydria. Due to this peculiar intra-gastric environment, gastric microbiota composition in individuals with autoimmune atrophic gastritis was first supposed and then recently reported to be different from subjects with a normal acidic healthy stomach. Read More

Cardiol Young 2021 Jan 13;31(1):141-143. Epub 2020 Oct 13.

Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain.

A 10-year-old girl with genetically confirmed Jervell-Lange-Nielsen syndrome treated with beta-blocker and developed electrical storm after changing propranolol syrup to tablets. Jervell-Lange-Nielsen is characterised by long QT and congenital sensorineural deafness, with high risk of malignant arrhythmias at early ages. Gastric involvement and achlorhydria may be present, with subsequent alteration of medication bioavailability which can trigger severe arrhythmic complications. Read More

Dig Dis Sci 2021 05 25;66(5):1442-1445. Epub 2020 Sep 25.

Department of Pathology, El Camino Health, Mountain View, CA, USA.