Causes and consequences of hypochlorhydria in the elderly.

Abstract

A workshop entitled "Causes and Consequences of Hypochlorhydria in the Elderly," cosponsored by the National Institute on Aging; the National Institute of Diabetes, Digestive and Kidney Diseases; and the USDA Human Nutrition Research Center on Aging, was held on September 28 and 29, 1987, in Bethesda, Maryland. The workshop was organized following discussions by Drs. Holt, Rosenberg, and Russell, members of the Council on Aging of the American Gastroenterological Association, and Drs. Evan Hadley and Van Hubbard of the NIH. The conference was introduced as an opportunity to review the state of knowledge about hypoand achlorhydria and the research opportunities in respect to nutritional and metabolic consequences. Dr. John Fordtran (Baylor University Medical School) began by reviewing age-related changes in gastric secretion. He noted there was no uniform definition of hypochlorhydria in the literature. He suggested that a reasonable definition of hypochlorhydria was: acid production following a standard meal stimulus in well-defined normal subjects which was two standard deviations below the mean. The normals would need to be a group of subjects with normal gastric biopsies and no evidence of active Campylobacter infection. In early life, gastric acid output reaches adult levels by 24 weeks of age. The average rate of acid secretion by the stomach does appear to fall with advancing age but this may well be due to a higher prevalance of hypochlorhydria in individual subjects among this age group. Indeed,