Age-Related Decline of Gastric Secretion: Facts and Controversies

Aging is associated with structural and functional changes in the gastrointestinal tract; however, its impact on gastric secretion remains unclear. This scoping review examines whether gastric secretion declines with age and explores its clinical implications. Following the PRISMA guidelines, PubMed...

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Main Authors: Francisco Vara-Luiz, Ivo Mendes, Carolina Palma, Paulo Mascarenhas, Gonçalo Nunes, Marta Patita, Jorge Fonseca
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1546
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author Francisco Vara-Luiz
Ivo Mendes
Carolina Palma
Paulo Mascarenhas
Gonçalo Nunes
Marta Patita
Jorge Fonseca
author_facet Francisco Vara-Luiz
Ivo Mendes
Carolina Palma
Paulo Mascarenhas
Gonçalo Nunes
Marta Patita
Jorge Fonseca
author_sort Francisco Vara-Luiz
collection DOAJ
description Aging is associated with structural and functional changes in the gastrointestinal tract; however, its impact on gastric secretion remains unclear. This scoping review examines whether gastric secretion declines with age and explores its clinical implications. Following the PRISMA guidelines, PubMed, Web of Science, Embase, and Google Scholar were systematically searched from inception to December 2024. Fifteen studies (both animal and human) met the inclusion criteria: they were written in English, directly relevant to aging and gastric secretion, and had a clearly stated methodology. Evidence strength was assessed using the GRADE framework, revealing predominantly low to moderate certainty due to small sample sizes and observational study designs. Animal studies have demonstrated reduced acid secretion in older rats, which is attributed to mucosal atrophy and diminished responsiveness to gastrin. Recent human studies suggest that aging does not directly reduce acid output, as reduced acid secretion may result from a higher prevalence of atrophic gastritis, <i>Helicobacter pylori</i> infection, and the widespread use of proton pump inhibitors. Antisecretory therapy may lack benefits in older adult patients with hypochlorhydria/achlorhydria and increase the risk of adverse effects. Pepsin output declines with aging due to reduced chief cell function, although its clinical impact on digestion is unclear. Since intrinsic factor secretion far exceeds the amount necessary for its physiological function, even low amounts seem to be sufficient to prevent cobalamin deficiency. Age-related decline in gastric secretion is mostly attributed to age-associated disorders; however, impairment of secretory function in older people is frequent. Future research should prioritise longitudinal studies, larger cohorts, and histology-stratified analysis.
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spelling doaj-art-135f1e1bfbdf4c3ea128586b6d4e10232025-08-20T04:00:54ZengMDPI AGBiomedicines2227-90592025-06-01137154610.3390/biomedicines13071546Age-Related Decline of Gastric Secretion: Facts and ControversiesFrancisco Vara-Luiz0Ivo Mendes1Carolina Palma2Paulo Mascarenhas3Gonçalo Nunes4Marta Patita5Jorge Fonseca6Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalGastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalGastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalAging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, PortugalGastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalGastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalGastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, PortugalAging is associated with structural and functional changes in the gastrointestinal tract; however, its impact on gastric secretion remains unclear. This scoping review examines whether gastric secretion declines with age and explores its clinical implications. Following the PRISMA guidelines, PubMed, Web of Science, Embase, and Google Scholar were systematically searched from inception to December 2024. Fifteen studies (both animal and human) met the inclusion criteria: they were written in English, directly relevant to aging and gastric secretion, and had a clearly stated methodology. Evidence strength was assessed using the GRADE framework, revealing predominantly low to moderate certainty due to small sample sizes and observational study designs. Animal studies have demonstrated reduced acid secretion in older rats, which is attributed to mucosal atrophy and diminished responsiveness to gastrin. Recent human studies suggest that aging does not directly reduce acid output, as reduced acid secretion may result from a higher prevalence of atrophic gastritis, <i>Helicobacter pylori</i> infection, and the widespread use of proton pump inhibitors. Antisecretory therapy may lack benefits in older adult patients with hypochlorhydria/achlorhydria and increase the risk of adverse effects. Pepsin output declines with aging due to reduced chief cell function, although its clinical impact on digestion is unclear. Since intrinsic factor secretion far exceeds the amount necessary for its physiological function, even low amounts seem to be sufficient to prevent cobalamin deficiency. Age-related decline in gastric secretion is mostly attributed to age-associated disorders; however, impairment of secretory function in older people is frequent. Future research should prioritise longitudinal studies, larger cohorts, and histology-stratified analysis.https://www.mdpi.com/2227-9059/13/7/1546aginggastric secretionchronic atrophic gastritis<i>Helicobacter pylori</i>precision medicine
spellingShingle Francisco Vara-Luiz
Ivo Mendes
Carolina Palma
Paulo Mascarenhas
Gonçalo Nunes
Marta Patita
Jorge Fonseca
Age-Related Decline of Gastric Secretion: Facts and Controversies
Biomedicines
aging
gastric secretion
chronic atrophic gastritis
<i>Helicobacter pylori</i>
precision medicine
title Age-Related Decline of Gastric Secretion: Facts and Controversies
title_full Age-Related Decline of Gastric Secretion: Facts and Controversies
title_fullStr Age-Related Decline of Gastric Secretion: Facts and Controversies
title_full_unstemmed Age-Related Decline of Gastric Secretion: Facts and Controversies
title_short Age-Related Decline of Gastric Secretion: Facts and Controversies
title_sort age related decline of gastric secretion facts and controversies
topic aging
gastric secretion
chronic atrophic gastritis
<i>Helicobacter pylori</i>
precision medicine
url https://www.mdpi.com/2227-9059/13/7/1546
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