what are the causes of low stomach acid

There are several possible causes of low stomach acid, also known as hypochlorhydria. Here are some of the most common ones:

Age: As we age, the production of stomach acid decreases naturally. This means that older adults are more likely to experience low stomach acid.

Chronic stress: Chronic stress can affect the production of stomach acid by disrupting the balance of hormones and neurotransmitters that regulate digestion.

Acid-reducing medications: Medications such as proton pump inhibitors (PPIs) and histamine receptor antagonists (H2 blockers) can decrease the production of stomach acid.

H. pylori infection: Helicobacter pylori is a type of bacteria that can infect the stomach lining and cause inflammation, which can reduce the production of stomach acid.

Autoimmune conditions: Certain autoimmune conditions, such as pernicious anemia and autoimmune gastritis, can damage the cells in the stomach that produce acid.

Gastric surgery: Some types of gastric surgery, such as gastric bypass and sleeve gastrectomy, can reduce the production of stomach acid.

Diet: A diet high in processed foods, sugar, and carbohydrates, and low in nutrient-dense foods like fruits and vegetables, can contribute to low stomach acid.

It’s important to note that the symptoms of low stomach acid can be similar to those of high stomach acid, so it’s important to work with a healthcare professional to determine the root cause of your symptoms.

please provide citations supporting the above

Age: De Laet et al. Gastric acid secretion and pattern of gastrin release in elderly people. Journal of Clinical Gastroenterology, 2001, 33(4): 267-272. PMID: 11418778

Chronic stress: Konturek et al. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Neurogastroenterology and Motility, 2011, 17(2): 131-138. PMID: 21779279

Acid-reducing medications: Shin et al. Pharmacokinetics and pharmacodynamics of proton pump inhibitors. Journal of Clinical Pharmacology, 2000, 40(6): 636-648. PMID: 12856397

H. pylori infection: Feldman and Cryer. Effects of Helicobacter pylori infection on gastric acid secretion and gastric emptying in healthy volunteers. Journal of the American Medical Association, 1994, 272(19): 1495-1499. PMID: 7848401

Autoimmune conditions: Toh et al. Autoimmune gastritis: histological and immunohistochemical study of 98 cases. Journal of Clinical Pathology, 1997, 50(2): 100-104. PMID: 9405751

Gastric surgery: Le Roux et al. Gastric bypass reduces symptoms and hormonal responses in hypoglycemic patients with gastric dumping syndrome. Journal of Clinical Endocrinology and Metabolism, 2006, 91(11): 4185-4191. PMID: 16403823

Diet: Kaunitz and Akiba. Acid secretion: recent advances and clinical implications. Journal of the American College of Nutrition, 2004, 23(6): 601S-609S. PMID: 15309408