Abstract
Micronutrient deficiencies are relatively common, in particular iron and cobalamin deficiency, and may potentially lead to life-threatening clinical consequences when not promptly recognized and treated, especially in elderly patients. The stomach plays an important role in the homeostasis of some important hematopoietic micronutrients like iron and cobalamin, and probably in others equally important such as ascorbic acid, calcium, and magnesium. A key role is played by the corpus oxyntic mucosa composed of parietal cells whose main function is gastric acid secretion and intrinsic factor production. Gastric acid secretion is necessary for the digestion and absorption of cobalamin and the absorption of iron, calcium, and probably magnesium, and is also essential for the absorption, secretion, and activation of ascorbic acid. Several pathological conditions such as Helicobacter pylori-related gastritis, corpus atrophic gastritis, as well as antisecretory drugs, and gastric surgery may interfere with the normal functioning of gastric oxyntic mucosa and micronutrients homeostasis. Investigation of the stomach by gastroscopy plus biopsies should always be considered in the management of patients with micronutrient deficiencies. The current review focuses on the physiological and pathophysiological aspects of gastric acid secretion and the role of the stomach in iron, cobalamin, calcium, and magnesium deficiency and ascorbate homeostasis.
Highlights
Micronutrient deficiencies are relatively common worldwide and are recognized as a global public health issue [1,2]
The current review focuses on the physiological aspects of gastric acid secretion and the role of the stomach in iron, cobalamin, calcium, and magnesium deficiency and ascorbate homeostasis
Due to the peculiar intra-gastric environment characterized by impaired gastric acid secretion, the gastric microbiota composition in patients with autoimmune and nonautoimmune corpus atrophic gastritis has been reported to be different from subjects with a normal acidic healthy stomach allowing the survival and colonization of other bacterial strains than Helicobacter pylori [139,140], and gastric dysbiosis is supposed to be related to the increased risk of gastric cancer in this condition [17,141]
Summary
Micronutrient deficiencies are relatively common worldwide and are recognized as a global public health issue [1,2]. Ascorbic acid further promotes iron absorption, decreased bioavailability of this micronutrient may imply negative effects on iron absorption [11] Several pathological conditions such as Helicobacter pylori-related gastritis and corpus atrophic gastritis [5,6,12], as well as antisecretory drugs, especially proton pump inhibitors [13], and gastric surgery [14,15,16], may interfere with the normal functioning of the gastric oxyntic mucosa and micronutrients homeostasis. Taking into consideration the high prevalence of Helicobacter pylori infection all over the world, its role in micronutrient malnutrition may have paramount clinical implications: albeit a decreasing trend has been shown globally in the last years, yet more than 50% of people in the world are infected by Helicobacter pyloriand in Africa, Central and South America, a large part of the population is infected by Helicobacter pylori [18]. The current review focuses on the physiological aspects of gastric acid secretion and the role of the stomach in iron, cobalamin, calcium, and magnesium deficiency and ascorbate homeostasis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
