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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 2021 Apr 27. 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

Indian J Gastroenterol 2021 Jan 8. 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 2020 Dec 3. Epub 2020 Dec 3.

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

Int J Mol Sci 2020 Sep 3;21(17). Epub 2020 Sep 3.

Department of Upper Gastrointestinal Surgery, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia.

is a class one carcinogen which causes chronic atrophic gastritis, gastric intestinal metaplasia, dysplasia and adenocarcinoma. The mechanisms by which interacts with other risk and protective factors, particularly vitamin C in gastric carcinogenesis are complex. Gastric carcinogenesis includes metabolic, environmental, epigenetic, genomic, infective, inflammatory and oncogenic pathways. Read More

Am J Infect Control 2021 03 11;49(3):385-386. Epub 2020 Aug 11.

Novus International, Inc., St. Charles, MO. Electronic address:

COVD-19 disease is characteristically respiratory in nature; however, some patients have gastrointestinal symptoms. These include changes in taste, nausea/vomiting, abdominal pain, and diarrhea. A report has been published of a young patient who repeatedly tested positive in stool samples while nasopharyngeal tests remained negative. Read More

Therapie 2021 Jan-Feb;76(1):13-21. Epub 2020 Jul 9.

GITAM Institute of Pharmacy, GITAM University, Rushikonda, Visakhapatnam, 530045 Andhra Pradesh, India. Electronic address:

The long-term use of proton pump inhibitors (PPIs) can lead to increased gastric pH, hypochlorhydria and in some cases to achlorhydria when compared to other acid-suppressing agents like histamine-2 (H2) receptor blockers and antacids. These consequences by the use of long-term PPIs may lead to significant vitamin (B and C) and mineral (iron, calcium and magnesium) deficiencies which needs gastric acid for their absorption and bioavailability. Long-term use of PPIs by the pregnant patients may impose a potential risk of congenital malformations. Read More

J Med Virol 2021 Jan 15;93(1):166-167. Epub 2020 Jul 15.

Research and Development, St. Charles, MO.

FASEB J 2020 08 25;34(8):10699-10719. Epub 2020 Jun 25.

Experimental and Clinical Research Center, Berlin, Germany.

Heart failure (HF) is an increasing global health crisis, affecting 40 million people and causing 50% mortality within 5 years of diagnosis. A fuller understanding of the genetic and environmental factors underlying HF, and novel therapeutic approaches to address it, are urgently warranted. Here, we discovered that cardiac-specific germline deletion in mice of potassium channel β subunit-encoding Kcne2 (Kcne2 ) causes dilated cardiomyopathy and terminal HF (median longevity, 28 weeks). Read More

Clin Gastroenterol Hepatol 2021 Apr 14;19(4):707-712. Epub 2020 Mar 14.

Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. Electronic address:

Background & Aims: Menetrier's disease is a rare acquired disorder associated with giant gastric folds along with protein-losing enteropathy, low stomach acid, or achlorhydria, and histologic features of massive foveolar hyperplasia. Little is known about the etiology, clinical features, or epidemiology of this disorder, including risk of gastric cancer. We investigated the outcomes and characteristics of patients with Menetrier's disease, including development of gastric cancer and survival times. Read More

Cell Mol Gastroenterol Hepatol 2020 28;10(1):113-132. Epub 2020 Jan 28.

Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals, National Health Service Foundation Trust, Liverpool, United Kingdom. Electronic address:

Background & Aims: In patients with autoimmune atrophic gastritis and achlorhydria, hypergastrinemia is associated with the development of type 1 gastric neuroendocrine tumors (gNETs). Twelve months of treatment with netazepide (YF476), an antagonist of the cholecystokinin B receptor (CCKBR or CCK2R), eradicated some type 1 gNETs in patients. We investigated the mechanisms by which netazepide induced gNET regression using gene expression profiling. Read More

Nihon Shokakibyo Gakkai Zasshi 2020 ;117(1):84-91

Department of Pathology, Fukuyama City Hospital.

A 68-year-old woman with an 11-day history of sudden abdominal pain and severe watery diarrhea was transferred to our hospital due to an exacerbation of renal function despite hydration. After treatment for dehydration and acidemia was provided in our intensive care unit, patient's renal function improved. Contrast-enhanced abdominal computed tomography was finally performed, revealing a hypervascular pancreatic mass with multiple hepatic masses. Read More

Biosci Rep 2020 02;40(2)

Guangzhou University of Chinese Medicine, 232 Waihuan Dong Road, Panyu District, Guangzhou 510405, China.

Parietal cells of the gastric mucosa contain a complex and extensive secretory membrane system that harbors gastric H+, K+-adenosine triphosphatase (ATPase), the enzyme primarily responsible for gastric lumen acidification. Here, we describe the characterization of mice deficient in the H+, K+-ATPase α subunit (Atp4a-/-) to determine the role of this protein in the biosynthesis of this membrane system and the biology of the gastric mucosa. Atp4a-/- mice were produced by gene targeting. Read More

Wiad Lek 2019 ;72(11 cz 1):2104-2107

Pavlo Tychyna Uman State Pedagogical University, Uman, Ukraine.

Objective: Introduction: Gastric hypohlorhydria is the result of inflammatory process in the intestine caused by dysbiosis. Multiprobiotics significantly improve the colon's motility. Not only probiotics, but also synbiotics are used to eliminate dysbiosis. Read More

Int J Mol Sci 2019 Nov 29;20(23). Epub 2019 Nov 29.

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7006 Trondheim, Norway.

Gastric juice is a unique combination of hydrochloric acid (HCl), lipase, and pepsin. Acidic gastric juice is found in all vertebrates, and its main function is to inactivate microorganisms. The phylogenetic preservation of this energy-consuming and, at times, hazardous function (acid-related diseases) reflects its biological importance. Read More

Intern Med 2020 Mar 29;59(6):799-803. Epub 2019 Nov 29.

Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan.

Gastrin regulates gastric acid secretion, and gastrin secretion itself is regulated by the negative feedback system of gastric acidity. Autoimmune gastritis (AG) is a disease where parietal cells are destroyed, resulting in decreased acid production and an elevated serum gastrin level. We herein report 2 AG cases with marked hypergastrinemia (>5,000 pg/mL). Read More

Am J Case Rep 2019 Nov 22;20:1723-1727. Epub 2019 Nov 22.

Department of Pathology, Orlando Regional Healthcare, Orlando, FL, USA.

BACKGROUND VIPomas are rare neuroendocrine tumors typically located in the pancreas. The majority of cases autonomously secret vasoactive intestinal polypeptide (VIP), which can result in profuse, refractory, watery diarrhea. The fluid and electrolyte imbalance can progress to dehydration and profound hypokalemia, resulting in the watery diarrhea, hypokalemia, achlorhydria (WDHA) syndrome. Read More

Indian J Endocrinol Metab 2019 May-Jun;23(3):318-325

Imam Khomeini Hospital Complex, Faculty of Medicine, National Tehran University of Medical Sciences, Tehran, Iran.

Introduction: VIPoma is a neuroendocrine tumor that secrets vasoactive intestinal peptide and produces a well-defined clinical syndrome characterized by watery diarrhea, hypokalemia, hypochlorhydria and metabolic acidosis. The aim of this study to investigate clinical studies about diagnostic and therapeutic modalities of vipoma patients. In this retrospective study, all patients of vipoma were investigated. Read More

Int J Mol Sci 2019 Oct 16;20(20). Epub 2019 Oct 16.

Digestive Diseases Branch, NIDDK, NIH, Bethesda, MD 20892-1804, USA.

The use of proton pump inhibitors (PPIs) over the last 30 years has rapidly increased both in the United States and worldwide. PPIs are not only very widely used both for approved indications (peptic ulcer disease, gastroesophageal reflux disease (GERD), Helicobacter pylori eradication regimens, stress ulcer prevention), but are also one of the most frequently off-label used drugs (25-70% of total). An increasing number of patients with moderate to advanced gastroesophageal reflux disease are remaining on PPI indefinitely. Read More

Hinyokika Kiyo 2019 Jul;65(7):277-282

The Department of Urology, Hokkaido University Hospital.

A 45-year-old woman visited a local clinic with left-flank abdominal pain. Abdominal computed tomography (CT) revealed a tumor 20 cm in diameter in the left adrenal gland. She was referred to our hospital for further treatment. Read More

Gastric Cancer 2020 01 27;23(1):52-63. Epub 2019 Jun 27.

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

Background: Type I gastric neuroendocrine tumors (gNETs) arise from hypergastrinemia in patients with autoimmune chronic atrophic gastritis. According to the classical model, the gastric H+/K+ ATPase was the causative autoantigen recognized by CD4+ T cells in chronic autoimmune scenario that secretes IL-17 and correlates with parietal cell (PC) atrophy, which drives to gastric achlorhydria and increases the risk for gastric neoplasms. However, the mechanism by which the inflammatory response correlates with PC atrophy is not clearly defined. Read More