THE UNIVERSITY OF LAHORE

BDNS
ASSIGNMENT # 1
SUBMITTED TO : MA’AM TARA KHURSHEED
TOPIC: DIORDERS IN WHICH HYPER AND
HYPOCHLORHYDRIA TAKE PLACE

Loss of Stomach Secretions

In many people who have chronic gastritis, the mucosa gradually becomes more and more
atrophic until little or no gastric gland digestive secretion remains. It is also believed that in some
people autoimmunity develops against the gastric mucosa, which also leads eventually to gastric
atrophy. Loss of the stomach secretions in gastric atrophy leads to achlorhydria and,
occasionally, to pernicious anemia.
 HYPOCHLORHYDRIA
 HYPERCHLORHYDRIA

Achlorhydria (and Hypochlorhydria).

Means simply that the stomach fails to secrete hydrochloric acid; it is diagnosed when the pH of
the gastric secretions fails to decrease below 6.5 after maximal stimulation. Hypochlorhydria
means diminished acid secretion. When acid is not secreted, pepsin also usually is not secreted.
Even when it is secreted, the lack of acid prevents it from functioning because pepsin requires an
acid medium for activity.
There are many diseases which caused by hypochlorhydria. Their names are following:

 lupus

 allergies

 asthma

 thyroid issues

 acne

 psoriasis

 eczema

 gastritis

 chronic autoimmune disorders

 osteoporosis

 pernicious anemia

Pernicious Anemia.
Pernicious anemia commonly accompanies gastric atrophy and achlorhydria. Normal gastric
secretions contain a glycoprotein called intrinsic factor, secreted by the same parietal cells that
secrete hydrochloric acid. Intrinsic factor must be present for adequate absorption of vitamin B12
from the ileum. That is, intrinsic factor combines with vitamin B12 in the stomach and protects it
from being digested and destroyed as it passes into the small intestine. Then, when the intrinsic
factor–vitamin B12 complex reaches the terminal ileum, the intrinsic factor binds with receptors
on the ileal epithelial surface, which in turn makes it possible for the vitamin B12 to be absorbed.
In the absence of intrinsic factor, only about 1/50 of the vitamin B12 is absorbed. In addition,
without intrinsic Factor, an adequate amount of vitamin B12 is not made available from the
foods to cause young, newly forming red blood cells to mature in the bone marrow. The result is
pernicious anemia.

Osteoporosis:
Osteoporosis is a condition that affects the bones. Its name comes from Latin for “porous bones.”
It may cause by hypochlorhydia because of low secretion on HCL. The inside of a healthy bone has
small spaces, like a honeycomb. Osteoporosis increases the size of these spaces, causing the
bone to lose strength and density. In addition, the outside of the bone grows weaker and thinner.
People with osteoporosis are at a high risk of fractures, or bone breaks, while doing routine
activities such as standing or walking. The most commonly affected bones are the ribs, hips, and
the bones in the wrists and spine. Without appropriate treatment, osteoporosis can worsen. As
bones get thinner and weaker, the risk of fracture increases. Symptoms of severe osteoporosis
can include a fracture from a fall or even from a strong sneeze or cough. They can also include
back or neck pain, or loss of height. Back or neck pain or loss of height can be caused by
a compression fracture. This is a break in one of the vertebrae in your neck or back, which is so
weak that it breaks under the normal pressure in your spine. If you do have a fracture from
osteoporosis, how long it takes to heal will depend on many factors. These include where the
fracture is, how severe it is, as well as your age and health history.

HYPERCHLORHYDRIA:
Hyperchlorhydria, sometimes called chlorhydria, sour stomach or acid stomach,[1] [2] refers
to the state in the stomach where gastric acid levels are higher than the reference range.
The combining forms of the name (chlor- + hydr-), referring to chlorine and hydrogen, are the
same as those in the name of hydrochloric acid, which is the active constituent of gastric acid.

In humans, the normal pH is around 1 to 3, which varies throughout the day. The highest basal
secretion levels are in the late evening (around 12 A.M. to 3 A.M.). Hyperchlorhydria is usually
defined as having a pH less than 2. It has no negative consequences unless other conditions are
also present such as gastroesophageal reflux disease (GERD).

There are many diseases which take place due to hyperchlorhydria some are following:
 Peptic ulcer
Peptic Ulcer
A peptic ulcer is an excoriated area of stomach or intestinal mucosa caused principally by the
digestive action of gastric juice or upper small intestinal secretions. Shows the points in the
gastrointestinal tract at which peptic ulcers most frequently occur, demonstrating that the most
frequent site is within a few centimeters of the pylorus. In addition, peptic ulcers frequently
occur along the lesser curvature of the amoral end of the stomach or, more rarely, in the lower
end of the esophagus where stomach juice frequently refluxes. A type of peptic ulcer called a
marginal ulcer also often occurs wherever a surgical opening such as a gastrojejunostomy has
been made between the stomach and the jejunum of the small intestine.

Basic Cause of Peptic Ulceration.

The usual cause of peptic ulceration is an imbalance between the rate of secretion of gastric
juice and the degree of protection afforded by the gastroduodenal mucosal barrier and the
neutralization of the gastric acid by duodenal juices. All areas normally exposed to gastric juice
are well supplied with mucous glands, beginning with compound mucous glands in the lower
esophagus plus the mucous cell coating of the stomach mucosa, the mucous neck cells of the
gastric glands, the deep pyloric glands that secrete mainly mucus, and, finally, the glands of
Brunner of the upper duodenum, which secrete a highly alkaline mucus. In addition to the mucus
protection of the mucosa, the duodenum is protected by the alkalinity of the small intestinal
secretions. Especially important is pancreatic secretion, which contains large quantities of
sodium bicarbonate that neutralize the hydrochloric acid of the gastric juice, thus also
inactivating pepsin and preventing digestion of the mucosa. In addition, large amounts of
bicarbonate ions Are provided in the secretions of the large Brunner glands in the first few
centimeters of the duodenal wall and bile coming from the liver. Finally, two feedback control
mechanisms normally ensure that this neutralization of gastric juices is complete, as follows:
When excess acid enters the duodenum, it inhibits gastric secretion and peristalsis in the
stomach, both by nervous reflexes and by hormonal feedback fromTherefore, a peptic ulcer can
be caused in either of two ways:
 excess secretion of acid and pepsin by the gastric mucosa
 Diminished ability of the gastroduodenal mucosal barrier to protect against the digestive
properties of the stomach acid–pepsin secretion.

REFERANCES:
 John e hall medical physiology edition 13
 healthline