Gastritis and PA Question

[Galixie]

As far as pernicious anemia goes, don't gastritis and autoimmune gastritis both result in the same problems?

I realize pernicious anemia specifically refers to the autoimmune disease, but I'm wanting to understand the difference in end result. Don't both cause a lack of absorption? Are we splitting hairs as far as the name of these two problems? Or is there something actually worse with autoimmune gastritis?

[fbirder]

Autoimmune gastritis specifically targets the cells that make Intrinsic Factor (required for B12 absorption) and hydrochloric acid.

Gastritis caused by general erosion of the stomach lining, such as that caused by overuse of NSAIDs like ibuprofen, attacks all of the cells of the stomach lining.

So the autoimmune version is more likely to hinder absorption of B12 (because of no IF) and other things like iron and protein (because of no acid).

[Galixie in reply to fbirder]

Yes, the destruction of intrinsic factor specifically would hinder absorption of B12, but if your paretial cells are being damaged through gastritis, then they can't make intrinisic factor, and the same absorption problem results, doesn't it?

[fbirder in reply to Galixie]

Yes, indeed.

But the gastritis caused by NSAIDs or by H. Pylori will affect the whole of the stomach, producing symptoms that will provoke investigation, often before malabsorption becomes very severe.

Because the autoimmune gastritis only affects a fraction of the cells in the stomach the symptoms it produces are far less obvious. So that form of gastritis is much more likely to exist unnoticed until the resulting absorption problems provoke a gastroscopy with histological examination.

[Polaris]

I agree, it's confusing Galixie. As you probably know, Heliocobacterpylori also causes gastritis and, if not tested for or diagnosed but treated only with PPIs, can result in B12 deficiency.

After a particularly long, debilitating, and dehydrating bout of gastritis that was treated only with Zantac, the root cause - H/Pylori - was only discovered after I paid for a private endoscopy.

ncbi.nlm.nih.gov/books/NBK2...

[slothycoffee in reply to Polaris]

Hi, I was wondering did you have an endoscopy done under the NHS before you had a private one?

[Polaris in reply to slothycoffee]

Hi slothycoffee. I had a really hopeless GP at the time who never listened or got to the root cause - I'd had to fight for diagnosis and optimum treatment for Hashi's Thyroid Disease and I never ever wanted to have such a prolonged and dreadfully uncomfortable bout of gastritis again. Three in my family had similar and landed in hospital where gall bladder problems suspected but only one confirmed and removed.

By the time I had the endoscopy, weeks of treatment with Zantac had probably healed gastritis and a scan had revealed no gall bladder problems. H/Pylori can be detected from a breath test without the need for an endoscopy but this had never been done!

[slothycoffee in reply to Polaris]

Thanks for your reply. I had an endoscopy done earlier this month and it showed I have chronic gastritis but no H.Pylori was found. I'm also taking zantac (I kept starting and stopping it as I had my doubts whether it was helping or not) but I'm going to take it for 4 weeks to see if there's any improvement.

Doctors don't even know why I have chronic gastritis, however, I don't remember having these problems until I started taking an antidepressant last year. I stopped taking it last month but still having indigestion pain sometimes.