Malabsorption of vitamin B12 after vagotomy

Streeter, A.M.; Duraiappah, Balasubramaniam; Boyle, Robert; O’Neill, Barry; Pheils, Murray T.

doi:10.1016/0002-9610(74)90169-x

Cited by 42 publications

(13 citation statements)

References 17 publications

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“…Clinical conditions associated with food Cbl malabsorption include gastric surgery, atrophic gastritis, bacterial overgrowth, and the use of acid‐suppressing drugs 30,31 . Although we did not specifically investigate for the causes of Cbl deficiency beyond measuring for IF‐Ab, none of the 40 Cbl deficient subjects had a history of surgery such as gastric resection, gastric bypass, or vagotomy that can result in food Cbl malabsorption 30–33 …”

Section: Discussionmentioning

confidence: 99%

Screening for Cobalamin Deficiency in Geriatric Outpatients: Prevalence and Influence of Synthetic Cobalamin Intake

Rajan

Wallace²,

Beresford

et al. 2002

J American Geriatrics Society

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Regular use of a multivitamin/synthetic Cbl source confers some degree of protection against Cbl deficiency in older adults. The relatively high prevalence rates and benefit of synthetic Cbl intake in this study reinforce recommendations that older adults should be screened for Cbl deficiency and should incorporate synthetic sources of Cbl as part of a balanced diet. Appropriate screening intervals and the optimal dose of supplemental Cbl to prevent Cbl deficiency remains to be determined.

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Section: Discussionmentioning

confidence: 99%

Screening for Cobalamin Deficiency in Geriatric Outpatients: Prevalence and Influence of Synthetic Cobalamin Intake

Rajan

Wallace²,

Beresford

et al. 2002

J American Geriatrics Society

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“…The greater potency of omeprazole to inhibit gastric acid secretion and the longer suppression of gastric acidity during the whole 24-hour period resembles the situation after vagotomy. Cyanocobalamin deficiency is known to develop in some patients after vagotomy (Streeter et al 1974).…”

Section: Absorption Of Cyanocobalamin (Vitamin B12) and Ironmentioning

confidence: 99%

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Creutzfeldt

1994

Drug Safety

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For the treatment of duodenal and gastric ulcer and reflux oesophagitis, especially erosive oesophagitis, omeprazole has an advantage over histamine H2-receptor antagonists because it heals significantly more patients significantly faster. Adverse effects have been observed during short term treatment with the same frequency as during treatment with H2-antagonists. Also, maintenance treatment with omeprazole of reflux oesophagitis is significantly superior to H2-antagonist therapy. During long term treatment for up to 8 years no further drug-related adverse effects have been observed. Moderate hypergastrinaemia occurs in some patients, especially if an omeprazole dosage of 40 mg/day is needed. A slight increase of the agyrophil (endocrine) cell volume density and an extension of micronodular hyperplasia in the oxyntic mucosa after several years of omeprazole treatment seem to be related to the severity of the corpus gastritis and not to drug-induced hypergastrinaemia, because similar changes have been observed in equal frequency in patients not receiving anti-secretory drugs. Theoretical arguments against long term treatment with potent acid-suppressing drugs, such as the possible consequences of gastric bacterial overgrowth or hypergastrinaemia, are not supported by clinical observations and epidemiological data and are, therefore, speculative.

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“…Intrinsic factor also mediates the absorption in the terminal ileum. Reduced cobalamin assimilation has been observed in patients with chronic gastric hyposecretion, such as during chronic atrophic gastritis [93,94,95,96], long-term therapy with PPIs [90] and after vagotomy [92, 97]. Especially subsets of Helicobacter-pylori -infected persons have an increased risk to develop cobalamin deficiency.…”

Section: Gastric Acid and Digestive And Mucosal Processesmentioning

confidence: 99%

“…Hypochlorhydria affects also the absorption of vitamin B 12 (cobalamin) [88,89,90,91,92]. The vitamin is protein bound and is released in the presence of acid and pepsin.…”

Section: Gastric Acid and Digestive And Mucosal Processesmentioning

confidence: 99%

Do We Need Gastric Acid?

et al. 2008

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Evidence from comparative anatomy and physiology studies indicates that gastric acid secretion developed during the evolution of vertebrates approximately 350 million years ago. The cellular mechanisms that produce gastric acid have been conserved over the millennia and therefore proton pump inhibitors have pharmacological effects in almost all relevant species. These observations suggest that gastric acid provides an important selective advantage; however, in modern-day humans the need for gastric acid can be questioned in light of the widespread use of safe and effective pharmacologic acid suppression. The Kandahar Working Group addressed questions concerning the need, production and effects of gastric acid, specifically: (1) motility in the upper gastrointestinal (GI) tract; (2) neuroendocrine factors; (3) digestive and mucosal processes; (4) microbiology, and (5) central processes and psychological involvement. We addressed each topic with the individual models available to answer our questions including animal versus human studies, pharmacologic, surgical as well as pathophysiologic states of acid suppression.

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Malabsorption of vitamin B12 after vagotomy

Cited by 42 publications

References 17 publications

Screening for Cobalamin Deficiency in Geriatric Outpatients: Prevalence and Influence of Synthetic Cobalamin Intake

Screening for Cobalamin Deficiency in Geriatric Outpatients: Prevalence and Influence of Synthetic Cobalamin Intake

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Do We Need Gastric Acid?

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