Epidemiology

The exact prevalence and incidence of achlorhydria are not known. Gastric corpus atrophy, defined by decreases in pepsinogen I and pepsinogen I/II ratio, is present in 10% to 15% of older people.[20][21][22][23][24]

Gastric corpus atrophy is reported to be present in 16% of dyspeptic patients.[25] Incidence rates of gastric corpus atrophy vary widely, ranging from 0% to 11% per year, with substantially higher rates observed in Helicobacter pylori-positive compared with H pylori-negative people.[26][27] In a population-based study from Sweden, the prevalence of atrophic corpus gastritis in participants aged 55 to 64 years old decreased from 124 per 1000 to 49 per 1000 individuals between 1990 and 2009, whereas the prevalence unexpectedly increased from 22 per 1000 to 64 per 1000 among participants aged 35 to 44 years old.[28] 

Gastric corpus atrophy is associated with intestinal metaplasia and carries a 2- to 3-fold increased risk for gastric adenocarcinoma.[24] Pernicious anaemia, a common cause of cobalamin deficiency, caused by auto-antibodies directed against intrinsic factor and/or parietal cells, affects >2% of people over the age of 60 years.[24] In a population study of 9684 German people aged 50 to 74 years, parietal cell antibodies, detected by enzyme-linked immunosorbent assay (ELISA), were present in 20% of subjects.[29] The parietal cell antibodies are directed against hydrogen-potassium-stimulated adenosine triphosphatase (H+/K+ ATPase), the proton pump of the parietal cell.[30][31]

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