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Pernicious Anaemia Society
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It feels like I'm getting sicker

I will probably never have an official PA diagnosis, but I'm a little worried that it means some of the common problems that tend to occur for PA patients might be overlooked in me simply because I don't have an official diagnosis.

After finally figuring out that some of my dizzy spells appear to be caused by gluten ataxia, I finally gave up gluten. The gluten issue has never previously caused me any gut problems, so lately I have been wondering why I keep getting a bloated feeling in my stomach every morning. It's been happening for over a month. The naturopath pointed out that it is unlikely to be SIBO because that usually gets better when one hasn't eaten anything in hours (such as during sleep). I'm wondering if it could be gastric atrophy and low stomach acid. Rather than send me for any testing, the naturopath suggested that it would probably be easier to just try taking some HCL and see if it helps. I'm a little leery about adding acid if that's not the problem though.

The only upper endoscopy I've had done did not show any gastric atrophy, gastritis, or h. pylori, (or celiac either), but that was back in 2010. I'm wondering if I should push for more testing or just try the HCL?

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You could always try the quick 'n' dirty test for achlorhydria..

Dissolve a teaspoon of baking soda in a glass of water and drink it first thing in the morning. If you have normal stomach acid then the soda will react with the acid to produce a large amount of carbon dioxide - which will want to escape as belching.

If you don't burp in two minutes (apart from dispelling any swallowed air) then you're probably low on stomach acid and could benefit from taking Betaine HCl with meals.


I've been belching a lot recently so I'm not sure I'd be able to tell the difference. We were thinking that if I am low on stomach acid the food is probably just sitting and fermenting in my stomach, which might explain the belching and the heartburn after eating.

One thing that really puzzles me is that I am gaining rather than losing weight. If I were low on stomach acid I shouldn't be gaining weight, right?


Hi border,

I will have to try that test. I haven't any idea if I have low stomach acid, PA or am ceolic.

B12d diagnosed in June (120). A few weeks later I asked for a IF test.

Reading 0. I was told it was normal.

If you have a chance, I would appreciate if you had a look at my profile.

I posted my recent bloods on TUk yesterday and asked admin could they copy and paste them onto PAS forum. I tried without success.

What do you suggest please.



Sorry this fast texting is too fast for me. fbirder. Haha


After your endoscopy did you get the pathology results? I had an endoscopy and was told it was normal by the gastroenterologist. I asked for the pathology report and it said that it showed some chronic gastritis. Picking up the damage to the stomach before full blown atrophy is apparently quite difficult - but there is evidence that even before atrophy the levels of gastrin are raised. Gastrin goes up when stomach acid is low to try to increase the production of acid. It is this increase in gastrin which can be dangerous for the stomach (look up hypergastrinemia) and it can be tested for (blood test for serum gastrin which needs to be taken after fasting).

I also have bloating and burping - was my first symptom. Then went on to be diagnosed with iron deficiency anaemia - iron needs stomach acid to be absorbed. No doctor has ever agreed with the likelihood of low stomach acid - in fact GP prescribed PPIs (which I didn't take).


You can get a blood test for serum levels of gastrin. If they're high it's a good sign of gastric atrophy. Here's a good presentation that explains it...


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Good link, thanks.


Yes, I got the pathology report. Here is what it said:


Esophagus Lumen A gaping lower esophageal sphincter was noted; there were no esophageal erosions.

Stomach Mucosa Normal mucosa was noted in the stomach. Multiple cold forceps biopsies were performed for histology in the fundus. Specimens sent to the lab.

Duodenum Mucosa Normal mucosa was noted in the duodenum. Multiple cold forceps biopsies were performed for histology in the second part of the duodenum. Specimens sent to the lab.


- Abnormal gastroesophageal junction, with a poorly developed flap valve and incompetent reflux barrier.

- Normal mucosa in the gastric fundus; no visual evidence of chronic atrophic grastritis. (Biopsy).

- Normal mucosa in the duodenum. (Biopsy).

Biopsy results:

A. Duodenal Biopsies: small bowel mucosa with no diagnostic alterations.

B. Biopsies Gastric: gastric fundal mucosa with no diagnostic alterations."

I might have to ask about that serum gastrin test. It is interesting that it is sometimes used to diagnose PA as well. I wonder if the naturopath was reluctant to do it because it is mainly done to check for cancer?

Is anion gap related to stomach acid production at all? Or are those totally different?


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