Gastric acidity in cholera and noncholera diarrhoea

Gastric acid production, unstimulated and following stimulation with betazole hydrochloride, was measured in Indian men with cholera or acute vibrio-negative diarrhoea-Measurements were made during acute illness and after different periods of convalescence. Men from the same socioeconomic group and from a higher one served as controls. Stimulated acid production was severely reduced during diarrhoea caused by V. cholerae and related vibrios but not during acute vibrio-negative diarrhoea. Acid production returned to stable convalescent values 1-3 days after cessation of diarrhoea. Stimulated acid production was significantly lower in controls from the lower socioeconomic group than in those from the higher socioeconomic group. Achlorhydria that did not respond to betazole administration occurred in 32% of the convalescent cholera patients but in none of the controls or convalescent vibrio-negative diarrhoea patients. It is concluded from these results that diarrhoea produced by V. cholerae and related vibrios is accompanied by transient inhibition of gastric acid secretion, that cholera occurs largely in a population with impaired acid secretion, and that preexisting achlorhydria may predispose to infection with V. cholerae.