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Pernicious Anaemia Society
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Low stomach acid

I have been having pain under my ribs and constant burping for about six months now. Countless trips to the Doctors along with my own Google research, I was finally tested for B12. I was deficient and put on 6 loading doses in 2 weeks with follow up boosters every 3 months for a year. I had a test for pernicious anemia which came back negative. Mostly my symptoms have gone. I am suffering still with burping and rib pain. After my second booster it went away. I had an ultrasound which found calcium on my spleen but no enlargement. Since then I’ve had various bowel and tummy issues including constipation and undigested food in my stool but no burping or rib pain. The doctor prescribed me Omeprazole on Monday which I have read lowers Stomach acid. The rib pains and burping have returned. Is it possibly stomach acid related. Could these be B12 deficiency too? What could be the cause of B12 deficiency if not Pernicious Anemia?

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HI itchy, I am self diagnosing as my tests came back negative but I have Hashimoto's with all the b12 deficiency symptoms. I don't know what causes it and there are a lot of people on here that have tested negative but might have a b12 issue. I have terrible stomach problems like you and the thing that helped me the most with bloating and gas was a product called restore4life.com You can buy it from the website or on amazon. It worked great and stopped all my bloating and gas. I was also having nausea, stomach pain and a motility issue and took iberogast for awhile and keep it on hand to have. It also helped me a lot so I could eat normal again. But for the bloating and gas the restore4life.com helped right away. There are a lot of people on here that can explain the b12 deficiency issue as I tested negative for everything but they say it is common in people with autoimmune diseases and especially hashimoto's which is why I am self diagnosing as the docs could not help me. I am on my 17th injection as of today. They say it can take a couple of months or even years to get better. I hope not. I feel a little better but not great yet. I am hoping to. I wish you well and I hope this helps.

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Thank you. It's horrible to feel so out of control with things and having to wait weeks for appointments for a doctor to tell you it's IBS or just the way you are built. I'm sure these new tablets have meant my rib pain etc has returned and I really have low stomach acid and not high. It makes me loose all faith in doctors when they just see me about each individual problem rather than my symptoms as a whole. I hope things improve with you soon. My dad has Hashimotos

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Hello Itchy, the same happened with me. I have been to abou 5 Gi doctors and they all tell me the same thing. there is nothing wrong with my stomach. Well , how can that be when I have stomach problems all the time? It has really gotten better with restore4life.com so I hope you try it and get relief. I am on my third bottle and my stomach issues have gotten so much better. I don't know why it works but it does. It was invented by an doctor who I think was and endocrinologist. You are not alone as i am in the same boat. I believe I have low stomach acid. Oh, also betaine hcl really helps with low stomach acid. I take it at every meal and my stomach is even better now than it was. As wedgewood explained, the lack of the intrinsic factor can affect the stomach acid even though we test negative we can still have it. I wish you well and hope this helps.

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Thank you. Will order some now. Happy to try anything x

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Ok, good luck to you. I wish you well.

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I was about to suggest Betaine HCI, I get mine from Lamberts x

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It works for me!

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It is quite possible that you have PA . The test used to diagnose it is so unreliable . Many people test negative who really do have PA . It is the IFA test ( Intrinsic Factor Antibody Test) The antibodies attack the parietal cells in the stomach , which secrete the Intrinsic Factor and stomach acid , both of which are necessary to absorb VitaminB12 from food ( meat , fish , dairy products and eggs . Lack of acid upsets the stomach flora about which we hear so much nowadays . i.e. all the various probiotic bacteria that are essential to our good health. You are taking Omeprazole which will neutralise any stomach acid you have . This will not deprive you of vitamin B12 because you are having injections . But it makes absorbing other nutrients very difficult . I’m not surorised to hear that your tummy problems have returned now . Of course I’m not medically qualified , but I have PA , and had a bad time until I found a way to treat my stomach problems.( bloating , terrible burping and stomach pain ) My doctor wanted me to take Gaviscon which also neutralises stomach acid , but is not as drastic as a P.P.I.( Proton Pump Inhibitor e.g. Omeprazole) My Doctor had never heard of the fact that PA patients had low/no stomach acid . Hypochlorhydria/ Achlorhydria. . I did not take any Gaviscon . Instead I took a course of an expensive probiotic called Symprove . My stomach problems disappeared .

Organic raw Sauerkraut also works well as do other probiotic foods — Kimchi , real yoghurt ( not those sweetened ones). kefir etc. These can be made cheaply at home . Prebiotics also help . There are lots of books to read about looking after ones gut . They could also help. Personally , I would not go near any sort of acid - neutralising medication . We need our stomach acid . It’s very important in the digestive process. The Parmaceutical industry makes billions out of PPIs . You must try to establish good probiotic bacteria in your gut .

I’m only telling you what I did to solve my stomach problems . I hope that it could work for you . If you did follow some of these suggestions , and they didn’t work for you , you will have done yourself no harm , which is more than one can say for Omeprazole . Very best wishes .

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Thank you. We are both of the same thinking. I think I will stop the omeprazole and see if rib pains stop. I am sure that is causing it. I must get better at the probiotics. I had a disasterous attempt at making sauerkraut (instead I grew my own penicillin!) I will stock up on kefir until I can master the art!

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Hi Wedge, I am always looking to improve my stomach even more. I looked up that symprove and you are right it is expensive. I was just curious because I still have a weak stomach even though the restore4life has helped me tremendously. what were your stomach issues that the symprove resolved? The reason I ask is the restore really helped my bloating and gas but i always get some burning in my upper stomach from certain meds, foods and supplements so I still have a weak stomach to an extent. What exactly were your specific stomach symptoms that it helped? i would like to know as it is quite expensive but if it could resolve all your stomach issues completely I am interested. I hope you are doing well. Thanks in advance for your reply.

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I had a terrible bloated stomach , terrible burping ,nausea and stomach pains , so bad I had to lie down . My gastroenterologist told me that PA patients have low or no stomach acid caused by the antibodies that attack the parietal cells .I said I wanted to be tested for stomach acid , but he told me that that was not done in the UK , only in research situations - so there’s no NHS test , and no treatment.. So I had to find my own solution. I read of Symprove that was used successfully to treat IBS ,which seemed to have similar symptoms to my problem , so I tried it for 3 months . It was marvellous — it worked . But I could not afford to always take Symprove . I changed to probiotic capsules, which also kept those awful gut problems at bay. The more I read about “gut” problems , the more I realise we can help them by natural means — all the fermented foods that contain those probiotics we need . I’m thinking about going on a course to learn how to make them at home.Sauerkraut , yoghurt, kefir and kimchi . I’ve even found some very good fermented beetroot juice . . I also find that acidic drinks are good for my gut . I have not taken Symprove for a couple of years, but I have no more of those symptoms , and I want it to stay that way !

, I do hope that you find a solution to your problems too . Best wishes .

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Hello Wedge, thanks for the info. I have been on probiotics for years and the restore4life has really helped my bloating, gas and nausea. I am now taking betaine hcl for low stomach acid but I still have a weak stomach. Such as I cannot seem to tolerate salad dressings, spices, certain things in frozen dinners. I don't know why. It seems to bother my upper stomach which i think is why it is low stomach acid. From what I understand probiotics don't help that. They help the lower abdominal pain. Perhaps when the b12 starts to heal me it will get better. I hope it won't be like this forever as I never had stomach issues before june 2017. I tried chinese herbs but they were too strong. I might try zinc carsonine next to strengthen my stomach as that is supposed to be really good for stomach issues. Thanks again and I wish you well.

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Hi Wedgewood can I ask how bad Symprove tastes? I think low stomach acid is my daughters problem as she burbs like an old navie and has frequent left side pain under her rib. She can also be on the loo within 30 mins of eating (we think this is dairy though and have eliminated it but other problems still persist). I tried her with Apple Cider vinegar with the mother but she said it tasted horrible. Don’t want to waste a load of money on it for she won’t drink it. I’m assuming you take a shot glass size amount and can just knock it back in one go? Thanks

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Yes that’s right , that’s what I did ( don’t take it anymore now that I’ve recovered from those symptoms . ) There is a passion-fruit flavoured Symprove . It is certainly more palatable than the plain ariety . Symprove is water- based , unlike many probiotics . It needs to br kept in the fridge once opened . Best of luck for your daughter .

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Hi itchy islander. I had the same rib and stomach pain as you. Long story but was put on every ppi possible (plus antibiotics etc) and it became increasingly worse and i also ended up with major gut dysbiosis/infections. I was at the point of not being able to eat at all as it was so painful. I started taking zinc, b12 and D - slowly - on recommendation of a leading gastro doc here in Australia and my stomach quickly started healing. I can now eat 80% normally again and am getting better:)

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Thank you for all your comments. Lots of things to try. I'm stopping the omeprazole to see if that helps and off shopping for various probiotics today. I'm happy to hear you have all found something that works for your symptoms. I just keep thinking if I was a car I would be easier to fix!

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I’ve found stomach enzymes (available as supplements) are a godsend - take 1/2 hour before a big meal in addition to good probiotics - and noooo omeprazole. I’ve found doctors are far too quick to decide that your problem is too much acid when in fact it is too little! Good luck!

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Dear Itchyislander: All the support here shows you are not alone with stomach problems and B12 issues. If I understand, you took B12 for some time and then were told you are ok. What did they measure to find you "ok"? I they measured B12 in your blood, of course your blood levels were high from the treatment. But high blood levels don't really say you are better. And the B12 treatment doesn't take care of the stomach problems. Some of the other commenters here have good luck with fermented foods or lime juice. I have been aided by celecoxib (Celebrex brand name) which reduces inflammation of the stomach lining where autoimmune antibodies attack cells that help B12 absorption. Only one study of this medication has been done so far with autoimmune atrophic gastritis (what we have), and it was an animal study. But celecoxib is taken to reduce arthritis inflammation, and the stomach problem with B12 conditions also is inflammatory, so the logic is there. Just wanted to describe another alternative to think about. Sometimes the gastric issues are overlooked, but they can be debilitating. I wish you well in finding treatment that will stabilize your health.

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Ever since I had my gallbladder removed a few years ago I've had problems with stomach pains, gas, undigested bits in my stool, etc. i just started taking a supplement containing HCL with betatine. It seems to be helping with my digestive problems. I only take one capsule with whatever large meal I have each day. Usually with lunch or dinner.

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Don't take Omeprazole if your b12 low it would make things worse

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I have PA and have experienced a lot of the same symptoms as you. I went to the gastro and was told start taking a P.P.I. Prior to my visit I had heard that people with PA have low stomach acid and that apple cider vinegar does the trick. I asked my gastro and he was clueless. I decided to at least give it a try and I am so glad that I did. The next time I was experiencing the burning I took a couple of tablespoons of apple cider vinegar and within a few minutes the pain was gone. I have tried apple cider vinegar tablets as well, from GNC, and they worked too. It's inexpensive and works great.

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Thank you all so much. It is reassuring to know that all these symptoms stem from one issue. I shall report back on how I get on with various suggestions to help anyone else that may search for the same issue. Omeprazole now in the bin (what a waste of a prescription charge!)

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Sounds like you have classic atrophic gastritis; very common among PA patients. I use pink bismuth chewable tablets to sooth the pain. I am scheduled for an upper endoscopy next month. My doctor's keep an eye out for precancerous cell types. There is not much else you can do. Take your B12 injectable and live large. Don't take drugs like Omeprazole. If anything, take digestive enzymes to aid in food digestion.

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Hi Itchy, I get these pains under my ribs, have them now, and I think trapped wind has a little to do with it. I read that B12d can alter the way the intestines flow and slow the muscle down. I’m sure I too have had low stomach acid for a long time, years before I was diagnosed deficient, but have had to work out everything for myself, as my GP thinks B12 deficiency is only fatigue and I’ve given up arguing x

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