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Pernicious Anaemia Society
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PA and high stomach acid?

I’m so confused! I was diagnosed with PA over a year ago. I tested positive to the intrinsic blood test, and I give myself B12 shots every 10 days.. But I’ve also continued to have terrible gastrointestinal problems. I read here that PA causes low acid, but I do seem to have a lot of acid. I’m on a PPI and triedtogo off and was definitely worse. My gastroenterologist says he doesn’t think that I have PA! I have an endoscopy scheduled for next month. Does anyone else have PA and high amount of acid? Thanks

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The symptoms of low stomach acidity are indistinguishable from those of high stomach acidity.

Unfortunately your body expects a certain level of acidity before it will stop producing gastric juices. If you don't actually make the acid - which happens with PA - then your body continues to produce gastric juices which can be very painful.

I occassionally get really bad heartburn. I find that taking some lime juice in water to introduce some extra acidity actually resolves it very quickly because my problem is low stomach acidity even though the symptom sounds like high stomach acidity.

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Thanks! Will an endoscopy help to confirm the low acid theory? Is there anything I should ask the gastroenterologist to test/ biopsy?

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gastro should see the damage to cells in the ileum.

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Pernicious Anaemia causes low / no stomach acid ( Hypochlorhydria / Achlorhydria) This is a fact . The antibodies that cause PA , attack the pareital cells in the stomach . These cells produce the “ Intrinsic Factor “ and also stomach acid , both of which are needed to absorb Vitamin B12 .

Stomach acic is extremely strong .If one drop was put on the skin, it would burn a hole . If you only have low/no stomach acid the oesophageal sphincter does not get the message to close tightly , so a little of the low acid escapes into the oesophagus , and causes “ heartburn”. If you take anti-acid medication , your stomach acid is neutralised , so you get no “heartburn” . This would be a good thing if only stomach acid didn’t playbsuch an important role in our good health . . As you are getting your B12 by injection , you are getting sufficient by by-passing the stomach . But other nutrients are suffering because of low/no acid . I also had gut problems when I was diagnosed with P.A. . No help from NHS . I found a solution inntaking pre and probiotics . You can do a simple test yourself to find out if you have low/ no stomach acid . Google “stomach acid test using bicarbonate of soda “ Your GP will laugh out loud if you tell him/her , but they will not test your stomach acid !

As you have tested positive for PA , I believe that your problem is low stomach acid , not high . In bad cases there are Hydrochloric acid capsules with pepsin ( Amazon .uk ) that you can take . Google how to use them . Acidic drinks are helpful too and Swedish bitters .

The lack of acid upsets the stomach flora , which you need to encourage with probiotics . Try a course of Symprove “;( expensive but very effective )

Best wishes .

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I meant to add that if you have PA , it’s important to chew your food really thoroughly , as the action of saliva is a help in breaking down the food when there is a lack of stomach acid .

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Many thanks for your reply. Do you know if an endoscopy is able to prove that you have either high or low acid?

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I have had an endoscopy , and it does not prove if you have high or low acid . In fact the gastroenterologist who performed the endoscopy , knew that my gut problems were associated with PA ,and told me so. He also told me that stomach acid was only tested “ in research conditions “ There is a procedure , but it is costly , and the NHS do not do it . In fact high stomach acid is apparently rare . The best thing to do is to perform a simple “ home made “ test with bicarbonate of soda — avogel.co.uk “ home test for low stomach acid “ The Test should be done first thing in the morning .

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I tried the bicarbonate test for the last 3 mornings and belch after 30 seconds, which indicates that I do have high acid, is that correct? And yet I test positive for PA! Is it possible to have PA and high acid?

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I would say that a reaction after 30 seconds would indicate that you have acid content , but not high acid . The longer one has had PA , the greater will be the damage to the parietal cells . Also do remember that this bicarbonate test is only a very rough one . . Your doctor will ridicule you if you tell him/her -mine did me ,

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Yes, I’m certain of the ridicule too! But I don’t know what to make of all this.

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My NET specialist tested stomach acid when I had my endoscopy and told me I have very low acid (almost nil) and high gastrin, so maybe some will test and others won't.

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Well, you really don’t know when doctors are telling the truth . Why was I told that testing for stomach acid was only done in research situations ? Thanks for that information . Stomach acid is so important for out health . It’s really important to be informed . My confidence in doctors is pretty well nil just like my stomach acid .

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That's really interesting, I had always thought that having the autoimmune Intrinsic Factor antibodies was a different mechanism to the low stomach acid malabsorption one. Also the info about the oesophageal sphincter not closing - I knew the low acid prevents the valve at the bottom of the stomach opening. I find my food often stays in my stomach far too long and I think that can contribute to my migraines. This tends to provide more opportunity for reflux too, just like my Mum with PA had.

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The same happened to me the acid was terrible then it got to the point I felt like I had none at all and my digestive system felt like it had dried up! Its a lot better now after being treated for H Pylori so I'm assuming that made it worse.

If you tested positive for Intrinsic Factor you have PA. I've also tested positive recently. I don't know a lot I'm no expert on here but I can definitely relate to your symptoms.

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Did you stop supplementing before your PA test? I want to do the test but my levels are quite good at the moment and I had been supplementing up until 2 weeks ago so don’t know whether it’s the best time.

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I think my last injection was 2-3 weeks before the IF test, I don't take oral supplements. I hope you get sorted out.

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Thank you 😊

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Thanks

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I will do that tomorrow morning! Many thanks

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Hi slap

I was first put on pp inhibitors by my NHS doctor for sever stomach pain

This continued until I could take no more. I paid to see a private Gp at a spire hospital

At that consultation he asked about my symptoms .life style,work etc

He then lay me on examination table and had a feel around stomach

His first words to me was we need to admit you to hospital

I passed to a consultant within minutes and on the ward I went all within 45 minutes

Hi had diverticulitis and was treated with iv antibiotics

Several blood test and scan later also shown pernicious amenia

I was given 12 loading shots of B12

Then one monthly

At this point I was passed back to my GP where we now have the well established and incorrrect treatment of PA with 3 monthly B12 injection.

‘‘Tis is not enough for me personally and I have now had to stay self injecting

Best regard

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I had the same problem before I was diagnosed with P.A. I tried to cut things out of my diet to identify what was causing acidity. But there was very little difference. This soon corrected itself after taking medication for PA. I used to take ranitidine for acid for some time and now very rarely suffer.

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Which medication for PA helps with your acid symptoms? I suffer quite badly and have tried everything.

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I was taking Omeprazole 20mg twice a day it didn't help an awful lot but now I've been treated for H Pylori the acid seems much more under control. It would be interesting to find out if you have H Pylori as the acid before was horrendous. When I slept it would come up and burn my throat and sometimes came gurgling up like a volcano through the day it was awful! H Pylori is quite common. Not sure about the UK but I know in Russia its 88% of the population and 65% in UAE. The gastroenterologist told me here In UAE. Let me know what happens.

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I have had problems with heartburn in the last year. My GP offered PPI but I declined. I read the Fast tract Diet and altered my diet. It is written by an MD Norman Robillard I think, who had gastrointestinal issues. He recommends limiting carbs as he says fermentation pushes stomach acid out of the top sphincter if the digestion takes too long. I have had excellent results from cutting sugar, fruit, fibre and carbs for a short period of time and then reintroducing at lower levels (I would now not eat a lot of bread or pizza for example as it would cause issues). White carbs are also bette than brown as they digest quicker.

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Thanks will give it a try

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If you have true pa, your stomach acid is probably low. I would get off of ppi. Is your pa diagnosed by your gp,? The gi doctor could be wrong. Doing B12 injections isn't going to hurt you, but only boost your blood level. Can't overdose. I also recommend an oral supplimemt of b complex. If your stomach hurts, try pink Bismuth for a week, at least 2 tabs 3 times a day. I have barret's esophagus and pa. Upper endoscopy at least every 3 years to watch for cancer. Vigorous Exercise 3 x a week for your mental health.

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I have also been diagnosed with PA, before this diagnosis 2 years ago I was diagnosed with Barrett's disease. I do have high Acid Reflux but for the past 3 year's I have had the most abhorrent pains in my chest, diaphragm and stomach. On Thursday NHS111 wanted to send an ambulance to take me to hospital but I declined because one I didn't want to put them out, two because my beautiful cat is dying from stomach cancer and I didn't want to leave her side. I only rang them for advice but I never expected them to want me to go to hospital. My GP was informed by NHS111 and she came out to visit me on Friday, ( yesterday). My Dr told me she was going to write to my consultant gastroenterologist to suggest repair surgery to my Hiatus hernia, immediately!!! I am so scared and pray the surgeon will be able to perform the less invasive surgery, but in a handful of cases they have to open the chest wall in order to repair the esophagus spincter with a special mesh. I am telling you all this because I don't want you to end up like me. Acid reflux caused the hole (spincter) in my esophagus to get bigger which inturn allowed my stomach to push itself into the chest cavity! I think the Acid corroded the esophagus spincter?? Please keep an eye on the amount of acid reflux you have because of the acid reflux I developed a Hiatal hernia and now I am facing an operation which nobody wants to happen do they? I know I don't! The reason I am so angry is because for 3 years I have suffered with the most terrible chest pains, yet nobody picked up on it - Why, I ask myself? What I want you to do is make sure your acid reflux is under control, if it gets too much then pester your doctor ok? I apologise for my anger which in no way is directed at you, I just don't want anyone else suffering unnecessarily. P.s. ask to have an Endoscopy to rule out any diseases, should your Gastroenterologist think it necessary he will take biopsies in any case.

Kind regards, keep well, keep save and be happy XX Marie xx

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Hi Marie

Thank you for all your advice , I will certainly keep an eye on reflux situation

Hope all goes well for you Steve

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Hi Steve

Thanks you for your kind reply, I just wanted to share my story in the hope my friend's on this site can avoid the thing's that could go wrong when Acid Reflux is neglected.

Kind regards

Marie x 😄

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Can I ask how long you have had acid reflux for? I’ve had it for a few years now and it worries me. I’m taking a PPI when it gets bad but I can feel it most days even if it isn’t really bad.

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I have acid reflux as well

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Here’s a link on How to check for proper stomach acid on YouTube.

Fbirder sent this to me a few days back. It’s a test to check if you’ve got too much or too little acid.

Let me know how you get on.

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Thank you Ryaan, I will check it out now😄 kind regards Marie x

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I have PA and my gastro said my acid reflux was due to low stomach acid, but I disagree with him for the reasons mentioned by so many of the posts below. I feel much better taking apple cider vinegar before meals. Taking the vinegar and chewing thoroughly while I eat has helped me lower the amount of bloating and pain. The endoscopies I've had did not show that I had low or high stomach acid, just gastritis. One other aspect that might play a role is the area that connects the esophagus to the stomach. In my case, a little bit of the stomach pokes through the opening to the esophagus, causing some of the little bit of acid I have to come up. Unfortunately not every gastro is informed about how PA really works. See what feel better for you, I hope you feel better soon.

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