Gastrointestinal and Liver Clinic and Endoscopy Unit, Vichaiyut Hospital, Bangkok, Thailand.
Excellence Center for Gastrointestinal Endoscopy, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
BMJ Open Gastroenterol. 2022 Aug;9(1). doi: 10.1136/bmjgast-2022-000976.
We aimed to study the prevalence of achlorhydria (AC) in a large Asian population.
Medical records of patients who underwent oesophagogastroduodenoscopy (OGD) with Congo red staining method at the Vichaiyut Hospital from January 2010 to December 2019 were retrospectively reviewed.
A total of 3597 patients was recruited; 223 were excluded due to concurrent use of proton pump inhibitors. Eighteen from 3374 patients (0.53%) had AC. Seven patients were presented with permanent AC (5F, 2M) (median age=69 years; range 58-92). Among 11 patients with temporary AC (5M, 6F: mean age 73.4 years; SD 13.2 years), all had gastrointestinal bacterial infection and were over 45 years old. After successful treatment for , AC was absent among patients with temporary AC. If counting only patients over 45 years of age, the prevalence of AC was 0.68% (18/2614). No adverse events arising from Congo red occurred.
AC is relatively rare. Permanent and temporary AC were found only when they were over 55 and 45 years old, respectively. Staining Congo red on gastric mucosa can be safely and routinely incorporated into the OGD procedure for early detection of AC. We recommended a low-cost screening test such as serum vitamin B levels for screening only in patients aged 50 and over.
我们旨在研究亚洲大人群中胃酸缺乏症（AC）的流行情况。
回顾性分析 2010 年 1 月至 2019 年 12 月在 Vichaiyut 医院接受刚果红染色法上消化道内镜检查（OGD）的患者的病历。
共纳入 3597 例患者，因同时使用质子泵抑制剂而排除 223 例。3374 例患者中有 18 例（0.53%）存在 AC。7 例为永久性 AC（5 例女性，2 例男性）（中位年龄=69 岁；范围 58-92 岁）。11 例暂时性 AC 患者（5 例女性，6 例男性；平均年龄 73.4 岁；标准差 13.2 岁）中，所有患者均存在胃肠道细菌感染且年龄均超过 45 岁。成功治疗后，暂时性 AC 患者的 AC 消失。如果仅计算年龄大于 45 岁的患者，AC 的患病率为 0.68%（18/2614）。刚果红染色未引起任何不良反应。
AC 相对罕见。仅在年龄超过 55 岁和 45 岁时才发现永久性和暂时性 AC。在上消化道内镜检查中常规使用刚果红染色胃黏膜可以安全且常规地用于早期发现 AC。我们建议仅对 50 岁及以上患者进行血清维生素 B 水平等低成本筛查试验进行筛查。
