Language
English
Publication Date
11-1-2022
Journal
Current Opinion in Gastroenterology
DOI
10.1097/MOG.0000000000000878
PMID
36165039
PMCID
PMC9561041
PubMedCentral® Posted Date
11-1-2023
PubMedCentral® Full Text Version
Author MSS
Abstract
PURPOSE OF REVIEW: Autoimmune gastritis is characterized by atrophy of acid secreting parietal cells resulting in achlorhydria. Upper gastrointestinal symptoms are common in autoimmune gastritis and frequently result in prescriptions for acid suppressant medications despite the inability of the stomach to secrete acid. Evidence-based recommendations for management of gastrointestinal symptoms in autoimmune gastritis are lacking.
RECENT FINDINGS: The most common symptoms in patients with autoimmune gastritis are dyspepsia, heartburn, and regurgitation. Gastroesophageal reflux should be confirmed by pH-impedance testing and is typically weakly acid or alkaline. Therapy for reflux focuses on mechanical prevention of reflux (i.e., elevation of the head of the bed and alginates) or when severe, antireflux surgery. The etiology of dyspepsia in autoimmune gastritis is unclear and largely unstudied. In the first half of the 20th century, oral administration of acid to "aid digestion" was widely used with reported success. However, randomized, placebo-controlled trials are lacking. Here, we provide suggestions for attempting gastric acidification therapy.
SUMMARY: Upper GI symptoms are common in autoimmune gastritis. Their pathogenesis and therapy remain incompletely understood. Acid suppressant medications are useless and should be discontinued. A trial of acid replacement therapy is recommended especially in the form of placebo-controlled trials.
Keywords
Alginates, Dyspepsia, Gastritis, Gastroesophageal Reflux, Heartburn, Humans, Autoimmune gastritis, dyspepsia, gastroesophageal reflux, achlorhydria, acid therapy
Published Open-Access
yes
Recommended Citation
, "Management of Upper Gastrointestinal Symptoms in Patients With Autoimmune Gastritis" (2022). Faculty, Staff and Students Publications. 1396.
https://digitalcommons.library.tmc.edu/baylor_docs/1396