How do B12D/PA, weakened stomach lining/gastritis and gallbladder relate? (And: use PPIs or not?)

[Hanneke12]

Hi all,

First of all: thank you for existing! I'm quite new here, and it's a warm bath and a valuable resource - I recognize so much of your struggles, and find there are many knowledgable persons. I'm stuggling at the moment, though, and I'd really like some of your wisdom.

I am still in the process of getting a PA/no PA diagnosis, but was tested B12 deficient in June of last year (157 pmol/L) and found out I was low in 2016 already (256). Have had many many symptoms for over a decade, I can give a list of them if needed, especially many debilitating neurological ones, but (relevant for my question): with hardly any stomach pain, though I did experience frequent reflux and belching after taking too many liquids). In my childhood I was diagnosed with a hiatal hernia (don't know if this is related, bu just mentioning it).

In the process of getting diagnosed, I recently (a bit over 3 weeks ago) had a gastroscopy showing weakened stomach lining/gastritis, a weak sphincter, and esophaghitus. And (and here it becomes relevant to complete my question): an ultrasound showing a 2,2 cm gallstone.

I am just starting my research, but -though my internist says the gallstone is probably an unrelated find- I have read gallstones occur more frequently in people with PA.

Furthermore, I was prescribed and currently am using esomeprazol, sucralfate and gaviscon to heal my esophagus and stomach. My stomach, that wasn't hurting before the gastro-endoscopy, strarted hurting the afternoon after the biopsies. That pain is actually getting better with the PPIs/antiacids, but: my gallbladder doesn't seem happy with any of it. I am trusting my internist and taking the medication to heal the inflammation in my stomach (am almost at week 3 and will only need 1-2 months). But: I am afraid of their effect on the gallbladder, which seems to be playing up more in the past weeks. Before, I didn't know I had a stone, nor what the symptoms of one are, I just connected everything with the B12D (which is a struggle in its own!)...but: I did have pain in my right shoulder, in my jaw, on the outside of my thighs, and had frequent belching, bloating and gas, and now also a dull pain under my right ribs...and I wake up during the night and am frequently awake for hours. And even though I have been injecting B12 (which of course is helping for several of the other symptoms: YAY B12!), my tinnitus has gotten worse since the PPIs. These could be B12D-related, but it's slowly dawning on me that these could also be gallstone related (could they?). And what to do then, take the gallbladder out? Or take different medications?

So I thought I'd ask you for your knowledge and experience: I'd much appreciate any useful information about the relationship between B12D/PA, stomach lining/gastritis and gallbladder disease. And: advice on whether I should use PPIs or not? Especially since I read that low stomach acid is associated with PA, meaning my gastritis/esophagitus must be due to either bile or food not being processed well. But I'm not sure yet if I have PA. In short: I don't know....

(To complete the picture: no H. Pylori was found during the gastroscopy, no atrophy, my folate and iron levels are fine, as is my THS. My anti-ENA blood test came back negative, I had a negative PCA and a negative IFA (though the latter I believe could be a false negative due to my supplementing with B12...). My last B12 serum test (in october) was 1264 but with and MMA of 0,26. No homocystein or gastrin tests done yet - would that be smart? Or anything gallbladder related?)

[SunnyWorld]

I have read somewhere (I've read too much it all gets mixed up) that gallbladder is related to these other things you mentioned just can't remember which, whether PA or PPI's. I had my gallbladder out around 6 yrs or so ago and b12 deficient before that.

[Hanneke12 in reply to SunnyWorld]

Thank you, @SunnyWorld. All info is welcome.

Are you happy with the gallbladder removal?

Hope you are able to manage the symptoms you had with B12 injections.

[SunnyWorld in reply to Hanneke12]

I didn't know I had a gallbladder problem I went for a scan about something else and it picked up the gallstones. I bet it was the H Pylori i had then as the stomache issues have gone on for years!

[fbirder]

If you were negative for Parietal Cell Antibodies, then that is a good indicator that you don't have PA. As is the lack of gastric atrophy.

I would continue with the PPIs. It sounds like they are helping the stomach situation (which suggests that you have high, not low acid). Their effect on B12 absorption is irrelevant if you're injecting.

[Hanneke12 in reply to fbirder]

Thank you fbirder . That's reassuring. Any idea about the B12 - gallstone relation?

[Hanneke12 in reply to Hanneke12]

Hi Fbirder, I found this: ncbi.nlm.nih.gov/pubmed/117..., stating that pernicious anemia increases the frequency of gallbladder stones. Don't know about the relation with B12 deficiency without PA.

[Alfabeta]

PPIs are listed as one of the causes of b12 deficiency on the NHS website. They’re all right for the short term but not long term.

Good luck.

[Alfabeta in reply to Alfabeta]

Addition - as Fbirder states, if you’re self injecting it won’t matter as you’re not relying on stomach acid.

[Hawkshaw2609]

I have been wondering the same thing as I had my diseased gallbladder removed aged 21 and suffer from low b12 PA? I have been prescribed antidepressants for the last 30 years since that operation and now think that low B12 has been the issue all along.

I have no medical confirmation for my suspicions but I am convinced there is a connection.

[Hanneke12 in reply to Hawkshaw2609]

I found this: ncbi.nlm.nih.gov/pubmed/117... stating that pernicious anemia increases the frequency of gallbladder stones. I don't know about the relation with B12 deficiency without PA....

[sbadd]

Wonder if related as i have been diagnosed low b12 but negative to PA, gallbladder polyps were found on a routine abdomen scan for bloating, which ive now been referred for surgery

[Hanneke12 in reply to sbadd]

Thanks for sharing, sbadd ! Please see my post to Hawkshaw2609 above.

[Marz]

Gall Bladder issues are often linked to Low Thyroid There is plenty of information on the net ! The stones can often contain cholesterol - which again is linked to low thyroid - low metabolism - causing the sluggish removal of cholesterol from the liver into the bloodstream ...

I had my gall bladder removed long before I was diagnosed with Hashimotos.