Description, Causes and Risk Factors:
Diminished or abolished secretion of gastric juice associated with atrophy of the mucous membrane of the stomach.
Achylia gastrica was first described by Fenwick in 1877. He then reported four cases that were undoubtedly progressive pernicious anemia characterized by a yellow discoloration of the skin, the absence of free hydrochloric acid in the gastric contents, the probable absence of ferments in the gastric contents as indicated by the undigested condition of the food, and a rapidly progressive and fatal course. He called these cases atrophy of the gastric mucous membrane. Quincke, Jaworski and others studied the condition at the same time. The literature is considerable; but, on the whole, it cannot be said that achylia gastrica has excited any great degree of attention on the part of the medical profession. This has been largely due to the fact that it is often merely a complication of certain other conditions, such as carcinoma, progressive pernicious anemia and amyloid disease, and that very often it may exist
The prognosis of cases of achylia gastrica is good in a view which I have represented in several papers and which is now generally accepted by most writers. The small intestine perfectly replaces the digestive work of the stomach, and the organism is not only enabled to maintain its equilibrium but also to gain in weight.
The symptoms for achylia gastricainclude indigestion, a feeling of fullness in the stomach after small meals, weight loss, hives and wheezing. Because gastric acid protects the intestinal system, in addition to digesting food, Achylia gastricais sometimes complicated by intestinal infections.People with Achylia gastricaare more likely to pick up bacterial and viral intestinal infections, such as traveler's diarrhea.In some cases, Achylia gastricacan be accompanied by nutritional deficiencies, such as pernicious anemia or a lack of calcium. Pernicious anemia, if present, is treated with vitamin B-12 shots and iron supplements.
To arrive at a diagnosis of achylia gastrica repeated examinations of the gastric contents are required for the detection of the above-mentioned characteristic points.The points of differential diagnosis between achylia gastrica and cancer of the stomach must be ruled out.
For the treatment of this condition giving all the findings of so-called achylia, first is the removal of the cause such as a chronic appendix, an infected gallbladder or an apical abscess. This may be all that is required, yet patients are frequently made more comfortable and recovery is hastened if attention is directed also to the patient's nutrition and the relief of an abnormal gastric condition. If total atrophy is not present and probably after several fractional tests free HCl is found one can reasonably hope for a return to a nearly normal secretion. If No HCl appears at any time the prognosis is bad regarding its ever being stimulated by any means. This point has been emphasized by Rehfuss, Held and Gross and others. It is to be remembered that any case showing HCl at any time is thereby removed from the achylia class.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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