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Alimentary Pharmacology & Therapeutics Jan 2006Proton pump inhibitors are potent drugs producing profound suppression of gastric acid secretion. Consequently, they are highly effective at treating acid-related... (Review)
Review
Proton pump inhibitors are potent drugs producing profound suppression of gastric acid secretion. Consequently, they are highly effective at treating acid-related disorders. There have been concerns that the suppression of gastric acid will alter the bacterial flora of the upper gastrointestinal tract and lead to complications such as cancer, enteric or other infections and malabsorption. Studies have confirmed that proton pump inhibitors do alter the bacterial population but present evidence indicates that this only rarely leads to clinical disease. As with all drugs, proton pump inhibitors should only be used for disorders shown clearly to benefit from the therapy and where the benefits will outweigh the small risks associated with them. Further research to more fully quantify the risk associated with PPI therapy is required.
Topics: Achlorhydria; Anti-Ulcer Agents; Bacterial Infections; Gastric Acid; Gastrointestinal Diseases; Humans; Nitrites; Proton Pump Inhibitors; Upper Gastrointestinal Tract
PubMed: 16393275
DOI: 10.1111/j.1365-2036.2006.02707.x -
Scandinavian Journal of Gastroenterology 2010Malabsorption of dietary calcium is a cause of osteoporosis. Dissolution of calcium salts (e.g. calcium carbonate) in the stomach is one step in the proper active and... (Review)
Review
Malabsorption of dietary calcium is a cause of osteoporosis. Dissolution of calcium salts (e.g. calcium carbonate) in the stomach is one step in the proper active and passive absorption of calcium as a calcium ion (Ca(2+)) in the proximal small intestine. Stomach acid markedly increases dissolution and ionization of poorly soluble calcium salts. If acid is not properly secreted, calcium salts are minimally dissolved (ionized) and, subsequently, may not be properly and effectively absorbed. Atrophic gastritis, gastric surgery, and high-dose, long-term use of antisecretory drugs markedly reduce acid secretion and may, therefore, be risk conditions for malabsorption of dietary and supplementary calcium, and may thereby increase the risk of osteoporosis in the long term.
Topics: Achlorhydria; Calcium; Calcium Metabolism Disorders; Dietary Supplements; Gastrectomy; Gastric Acid; Gastric Mucosa; Gastritis, Atrophic; Humans; Osteoporosis; Proton Pump Inhibitors; Risk Factors
PubMed: 19958055
DOI: 10.3109/00365520903434117 -
World Journal of Gastroenterology Jun 2019Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the... (Review)
Review
Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastric parietal cells, are used in the treatment of several acid-related disorders. PPIs are generally well tolerated but, through the long-term reduction of gastric acid secretion, can increase the risk of an imbalance in gut microbiota composition (., dysbiosis). The gut microbiota is a complex ecosystem in which microbes coexist and interact with the human host. Indeed, the resident gut bacteria are needed for multiple vital functions, such as nutrient and drug metabolism, the production of energy, defense against pathogens, the modulation of the immune system and support of the integrity of the gut mucosal barrier. The bacteria are collected in communities that vary in density and composition within each segment of the gastrointestinal (GI) tract. Therefore, every change in the gut ecosystem has been connected to an increased susceptibility or exacerbation of various GI disorders. The aim of this review is to summarize the recently available data on PPI-related microbiota alterations in each segment of the GI tract and to analyze the possible involvement of PPIs in the pathogenesis of several specific GI diseases.
Topics: Achlorhydria; Bacteria; Dysbiosis; Gastric Acid; Gastric Mucosa; Gastrointestinal Microbiome; Humans; Intestinal Mucosa; Proton Pump Inhibitors
PubMed: 31235994
DOI: 10.3748/wjg.v25.i22.2706 -
World Journal of Gastroenterology Mar 2008Gastric hypoacidity and hypergastrinaemia are seen in several conditions associated with an increased risk of gastric malignancy. Hypoacidity and hypergastrinaemia are... (Review)
Review
Gastric hypoacidity and hypergastrinaemia are seen in several conditions associated with an increased risk of gastric malignancy. Hypoacidity and hypergastrinaemia are closely related and their long-term effects are difficult to study separately in patients. Studies using animal models can provide valuable information about risk factors and mechanisms in gastric cancer development as the models allow a high degree of intervention when introducing or eliminating factors possibly affecting carcinogenesis. In this report, we briefly review findings from relevant animal studies on this topic. Animal models of gastric hypoacidity and hypergastrinaemia provide evidence hypergastrinaemia is a common causative factor in many otherwise diverse settings. In all species where sufficient hypoacidity and hypergastrinaemia have been induced, a proportion of the animals develop malignant lesions in the gastric oxyntic mucosa.
Topics: Achlorhydria; Animals; Cell Proliferation; Cell Transformation, Neoplastic; Disease Models, Animal; Enterochromaffin-like Cells; Gastric Acid; Gastric Mucosa; Gastrins; Humans; Receptor, Cholecystokinin B; Risk Assessment; Risk Factors; Stomach; Stomach Neoplasms
PubMed: 18350594
DOI: 10.3748/wjg.14.1646 -
JAMA Nov 1997
Topics: Achlorhydria; Aged; Gastritis, Atrophic; Humans; United States
PubMed: 9388081
DOI: No ID Found -
Gastroenterology Mar 1998
Topics: Achlorhydria; Helicobacter Infections; Helicobacter pylori; Humans
PubMed: 9496960
DOI: 10.1016/s0016-5085(98)70558-x -
Lancet (London, England) May 1974
Topics: Achlorhydria; Adolescent; Adult; Aged; Anemia, Pernicious; Autoantibodies; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Gastrins; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Radioimmunoassay; Skin Manifestations; Vitiligo
PubMed: 4132789
DOI: 10.1016/s0140-6736(74)90483-8 -
Zeitschrift Fur Gastroenterologie Nov 1979
Topics: Achlorhydria; Acute Disease; Adult; Gastritis; Humans; Iatrogenic Disease; Male
PubMed: 524961
DOI: No ID Found -
BMC Cancer Jul 2014A rare syndrome of watery diarrhea, hypokalemia and achlorhydria (WDHA) is usually caused by pancreatic endocrine tumors that secrete excessive vasoactive intestinal...
BACKGROUND
A rare syndrome of watery diarrhea, hypokalemia and achlorhydria (WDHA) is usually caused by pancreatic endocrine tumors that secrete excessive vasoactive intestinal polypeptide (VIP). Here we report a rare case of WDHA caused by a pheochromocytoma.
CASE PRESENTATION
A 45-year old male presented with persistent and progressive watery diarrhea for half a year, and was treated with dialysis due to azotemia, hypokalemia, hypercalcemia and metabolic acidosis. A right adrenal mass was found by ultrasonography, and Positron Emission Tomography-Computed Tomography (PET-CT) showed the tumor was hyper-metabolic. Levels of plasma normetanephrine (NMN) and serum chromogranin A (CgA) were significantly elevated. Immunohistochemistry analysis of the adrenal tumor was strongly positive for CgA, synaptophysin and VIP. The patient fully recovered from WDHA syndrome soon after surgery, as reflected in that diarrhea stopped, levels of plasma NMN, serum CgA, and electrolytes returned to normal thus no dialysis was needed. The patient remained disease free in a 12-months follow-up period.
CONCLUSION
We report an extremely rare case of pheochromocytoma causing WDHA syndrome and uremia, which the patient completely recovered from after tumor resection.
Topics: Achlorhydria; Adrenal Gland Neoplasms; Dialysis; Diarrhea; Disease-Free Survival; Humans; Hypokalemia; Male; Middle Aged; Pheochromocytoma; Treatment Outcome
PubMed: 25081061
DOI: 10.1186/1471-2407-14-553 -
Gastroenterology Oct 1955
Topics: Achlorhydria; Gastric Juice; Stomach Neoplasms
PubMed: 13270799
DOI: No ID Found