Achlorhydria medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Achlorhydria is often the result of another disease process, so the treatment is usually focused on the underlying condition.

For achlorhydria associated with immune-mediated conditions, such as insulin dependent diabetes, autoimmune thyroiditis, treatment of these disorders should also be the first. However, treatment of these diseases has no known effect in the treatment of achlorhydria.
The standard therapy for achlorhydria associated with H. pylori infection is to eradication H pylori by PPI plus clarithromycin plus amoxicillin. For patients who are allergic to penicillin, amoxicillin can be replaced by levofloxacin.
For achlorhydria resulting from anti-inflammatory medications, the treatment is stopping taking the drugs. If anti-inflammatory medications must be taken, the patient may benefit by ingesting them with meals or milk.
Treatment of gastritis that leads to pernicious anemia consists of parenteral vitamin B-12 injection.
Achlorhydria resulting from long-term PPI use may be treated by dose reduction or withdrawal of the PPI.
Antibacteria therapy: Antimicrobials such as metronidazole, amoxicillin-clavulanate potassium, ciprofloxacin, or rifaximin are suggested to treat bacterial overgrowth.
Nutritional supplementation
Dietary counseling