Effect of intravenous iron therapy on gastric acid secretion in iron-deficiency anaemia.

In patients with iron-deficiency anaemia, acid secretion was found to be reduced and was associated with chronic gastritis (Davidson and Markson, 1955; Joske, Finckh, and Wood, 1955; Badenoch, Evans, and Richards, 1957; Lees and Rosenthal, 1958; Floch and Meroney, 1962; Bock, Richards, and Witts, 1963; Dagg, Goldberg, Anderson, Beck, and Gray, 1964; Ikkala and Siurala, 1964; Cowan, Joseph, and Satija, 1966). However, in some patients with iron-deficiency anaemia, discrepancies were observed between the gastric mucosal lesion and acid output (Davidson and Markson, 1955; Glass, Speer, Nieburgs, Ishimori, Jones, Baker, Schwartz, and Smith, 1960; Adams, Glen, Kennedy, Mackenzie, Morrow, Anderson, Gray, and Middleton, 1964), suggesting that some other factors, such as anaemia and/or deficiency of an iron-dependent enzyme system, might also contribute to reduction in acid output (Floch and Meroney, 1962; Shearman, Delamore, and Gardner, 1966). After correction of the anaemia with oral or intramuscular iron, an increase in acid output was noted by some (Leonard, 1954; Badenoch et al., 1957; Jacobs, Lawrie, Entwhistle, and Campbell; 1966) while others reported neither histological nor functional improvement (Davidson and Markson, 1955; Floch and Meroney, 1962; Vaish, Sampathkumar, Jacob, and Baker, 1965); if anything, the changes worsened over a period of one year (Lees and Rosenthal, 1958). Jacobs et al. (1966) observed that the improvement in acid output, after correction of anaemia, occurs in patients under 30 years of age but not in elderly subjects. In a patient with irondeficiency anaemia, acid output was also studied within a week, before and after intravenous iron administration, to observe whether any iron-containing enzyme system was deficient and was responsible for reduction in acid output; the results were inconclusive (Shearman et al., 1966). The aim of this study was to observe the early effect of intravenous iron therapy on acid output (before the correction of anaemia) in patients with severe iron-deficiency anaemia. MATERIAL AND METHODS