Epidemiology

The exact prevalence and incidence of achlorhydria are not known. One single-centre retrospective study of 3374 patients who underwent oesophagogastroduodenoscopy in Thailand found a prevalence of 0.53%. All patients with achlorhydria were over 45 years old and had gastrointestinal Helicobacter pyloriinfection.[21]

​Incidence rates of atrophic gastritis vary widely, ranging from 0% to 11% per year, with substantially higher rates observed in H pylori-positive compared with H pylori-negative people.[8][22][23]​​​ The prevalence of atrophic gastritis and autoimmune gastritis increases with age.​[8][24]

​Gastric atrophy is associated with intestinal metaplasia and carries a two- to threefold increased risk for gastric adenocarcinoma.[25] Pernicious anaemia, a common cause of cobalamin deficiency, caused by auto-antibodies directed against intrinsic factor and/or parietal cells, affects >2% of people over the age of 60 years.[25] In a population study of 9684 adults aged 50-74 years, parietal cell antibodies, detected by enzyme-linked immunosorbent assay (ELISA), were present in 20% of study participants.[26] The parietal cell antibodies are directed against hydrogen-potassium-stimulated adenosine triphosphatase (H+/K+ ATPase), the proton pump of the parietal cell.[27][28]

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