Posted by Larry Hoover on May 23, 2005, at 11:13:45
In reply to Re: HELP! Enteric endocrine problems from psych m, posted by Krumcake on May 18, 2005, at 1:25:13
> P.S. I wanted to say too, achyorhydria & hypo ach- are two things I absolutely want to look into. Are there tests for these? To my knowledge he's never had a 24 hr pH monitor done. Should I even bother bringing these up with the docs or will they just start staring and drooling? Thanks!
Achlorhydria and/or hypochlorhydria are best assessed with a special probe. A pH sensitive electrode is placed in the stomach (usually via an endoscope), and left there to discover the pattern of acid level before during and after meals, overnight, and all that.
Alternatively, they use a naso-gastric tube (usually used for feeding), and use suction to draw stomach fluid out for analysis.
Although minor procedures, I think they are both usually done in an inpatient setting.
I think I've read about a portable monitor, though. They insert the electrode, and then you go home with a little belt-pack monitor, which records the pH over time.
http://www.emedicine.com/med/topic18.htm#target1
What is really bizarre is that this article does not overtly look at one obvious factor. Pernicious anemia is a cause of achlorhydria, and achlorhydria causes pernicious anemia. Also, long-term use of a proton-pump inhibitor (PPI, e.g. Nexium) causes the same problems.
Proving he has achlorhydria is one thing. Treatment is quite another. You don't need proof to start treatment. Vitamin B12 is a major part of the treatment. Although the RDA is something like 6 micrograms/day, the treatment here is 1 mg (1000 mcg)/day.
Betaine hydrochloride can help restore an acid environment. Taken just at the beginning of a meal, it not only contributes hydrochloric acid, it also supplies betaine, an alternative methyl source to the B12.
I also recommend bromelain. It's an enzyme found in pineapples. It helps control the inflammation associated with achlorhydria.
Lar
poster:Larry Hoover
thread:497418
URL: http://www.dr-bob.org/babble/alter/20050510/msgs/501675.html