Severe Salmonella Gastroenteritis Associated with Hypochlorhydria

Gray, J. A.; Trueman, Angela M.

doi:10.1177/003693307101600504

Cited by 37 publications

(4 citation statements)

References 9 publications

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“…(1) Non-typhoid salmonellosis : Before the entry of antisecretagous drugs, the best evidence for increased susceptibility to enteric infections following hypo/achlorhydria was the increased occurrence [79,80,81,82,83,84] and severity [80,85] of salmonellosis following gastric surgery inhibiting gastric acid secretion. The indications for gastric resection/gastrectomy in these studies were primarily peptic ulcer disease or gastric malignancy.…”

Section: Microbiological Consequences Of Removing Gastric Acidmentioning

confidence: 99%

The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid

Martinsen

Fossmark

Waldum

2019

IJMS

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Gastric juice is a unique combination of hydrochloric acid (HCl), lipase, and pepsin. Acidic gastric juice is found in all vertebrates, and its main function is to inactivate microorganisms. The phylogenetic preservation of this energy-consuming and, at times, hazardous function (acid-related diseases) reflects its biological importance. Proton pump inhibitors (PPIs) are one of the most widely used drugs in the world. Due to the reduced prevalence of Helicobacter pylori infection as well as the increased use of inhibitors of gastric acid secretion, the latter has become the most important cause of gastric hypoacidity. In the present manuscript, we review the microbiological consequences of removing gastric acidity. The resulting susceptibility to infections has not been studied extensively, and focus has mainly been restricted to bacterial and parasitic agents only. The strongest evidence concerning the relationship between hypochlorhydria and predisposition to infections relates to bacterial infections affecting the gastrointestinal tract. However, several other clinical settings with increased susceptibility to infections due to inhibited gastric acidity are discussed. We also discuss the impact of hypochlorhydria on the gut microbiome.

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Section: Microbiological Consequences Of Removing Gastric Acidmentioning

confidence: 99%

The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid

Martinsen

Fossmark

Waldum

2019

IJMS

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“…Subsequently, several studies confirmed this association (Close et al 1960; Sokol 1965; Giannella et al 1971; Buchin et al 1980). Also the severity of the salmonellosis was found to be correlated to previous gastric resection/gastrectomy (Nordbring 1962; Gray & Trueman 1971) or to reduced gastric acid secretion (Giannella et al 1973). The indications for gastric resection/gastrectomy in these studies were primarily peptic ulcer disease or gastric malignancy.…”

mentioning

confidence: 99%

Gastric Juice: A Barrier Against Infectious Diseases

Martinsen¹,

Bergh²,

Waldum³

2005

Basic Clin Pharma Tox

257

190

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All vertebrates produce gastric acid. Its main function is inactivation of ingested microorganisms. The majority of microbiological pathogens ingested never reaches the intestine because of the gastric barrier. Although gastric hypochlorhydria is fairly common due to atrophic gastritis, gastric surgery or use of inhibitors of gastric acid secretion, the resulting susceptibility to infection has not been studied extensively. Drug-induced blockade of acid secretion leads to gastrointestinal bacterial overgrowth; the clinical significance of this is still controversial. Gastric acidity is known to protect against non-typhoid salmonellosis and cholera and it is suspected that it protects against several parasitic diseases as giardiasis and strongyloides. There is a lack of studies focusing on the impact of the gastric acidic barrier on viral infections. Concerning prion infections only a single study has been performed, demonstrating a possible role of gastric acidity in the protection against foodborne prion disease in mice. The combination of malnutrition and hypochlorhydria may contribute to the high prevalence of gastrointestinal infections in developing countries. Further studies are needed to evaluate the clinical consequences of impaired gastric acidity with respect to susceptibility to infections.

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“…These adverse factors include the extremes of age, achlorhydria (Gray and Trueman, 1971), previous gastric resection (Waddel and Kunz, 1956), co-existent diseases, chronic haemolytic disease (Hook, Kaye and Gill, 1967), other debilitating disease (Mandell, Douglas and Bennett, 1979), immunosuppressive therapy (Hook,I96 1) and possibly therapy with antacids, oral antibiotics, and intestinal sedatives. Previous therapy with oral streptomycin markedly reduces the size of the infecting dose required to produce salmonella infections in animals (Miller and Bohnhoff, 1963).…”

Section: Discussionmentioning

confidence: 99%