digestion problems - b12 deficiency? - Pernicious Anaemi...

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digestion problems - b12 deficiency?

I have recently started treatment for a b12 deficiency and am currently receiving loading doses. I have also had bad problems with digestion for a while that manifests as bloating, frequent burping that feels suppressed, constipation and sometimes regurgitating when the burping is intense. I don't get heartburn but was originally thought to have acid reflux and was told to go on the no acidic/garlic/chocolate etc foods diet and it didn't work as the problems persisted. Problems instead seem to come from the size of a meal and in particular normal portions of meat. Since eating smaller meals I have some relief and I have reintroduced tomatoes with no problems. I assumed therefore I had low stomach acid as is typically the case with PA and have noticed the last couple of days I have had bloating issues return again after trying to eat more. Earlier today however I tried putting a tablespoon of lemon juice over my meal and it was no different to any other meal at first and it completely resolved the bad bloating that occurred after my breakfast. However in the hours after I got bad burping - not hugely major but worse than I have had for a while and as usual it feels 'suppressed' like I can't burp properly. I have no other symptoms just burping that has left a bad taste in my mouth. I also still burp after eating almost anything but it wasn't as bad as that. Surely if I had a low stomach acid problem the lemon wouldn't cause this? Like I said I have only just started my treatment but I'm struggling to understand what's going on here. Any insight from those who also have/had digestion issues?

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A member of my family has this problem . Eating little and often. Lemon juice or a little vinegar. Not eating too late or within a few hours of laying down. A bit of starchy food or yoghurt with food. Has given up gLuton and diary ( that might be just her though)no garlic or curry or onions. keeping still and upright straight after eating. She is also b12 deficient. A littke bit of root ginger boiled and sipped. Also get checked out to make sure it isn't anything else like a hernia. Hope you find some relief soon.

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Sorry to hear she has the same problem. I hope it gets sorted for her and thank you for all the tips.

owl87

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Have you gone gluten and dairy free to see if those are involved.

Also how much grease are you getting? Gall bladder issues- although you are not complaining of pain.

Any recent endoscopy to see if there is anything more sinister blocking the duodenum?

Anything you try you need to stick with that regime for 2 weeks to completely rid the hepatic loop (bile, liver, small intestine, portal vein) of the irritant.

The lime juice may just be a quantity issue. You are doing it for the acid content and not the taste.

How are you with salsa?

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I don't eat gluten or dairy since it was first thought I had IBS a few years ago. No endoscopy but considering asking doctor for a referral for one. I did wonder if it was just too much acid in one go on a likely sensitive stomach. Haven't had salsa for a while but I have fairly recently eaten a mild thai red curry sauce with no problems which is why I was so confused by the apparent reaction.

owl87

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I was thinking the other way like you didn’t get enough lemon juice with one tablespoon and needed more.

Apple cider vinegar- 2 tbls in a cup of warm water after a meal helps me. Not the distilled vinegars however as they contain gluten.

Have you been tested for heliobacter pylori infection?

Have you tried a tablespoon of honey before a meal? I think it is supposed to be Manuka honey from New Zealand.

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I think I am going to try the acv/lemon juice in water tomorrow and see how it goes! I am thinking it might have been an over consumption of carbohydrates that led to the episode - I'd increased amount and was experiencing severe bloating again. I cut back down the last few days on the starches and it seems to be helping. My doctor ordered a stool test - is that used for H. pylori? Thanks.

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I think heliobacter pylori test is now a breath test or an endoscopy and biopsy.

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It might be worth asking your Dr to refer you to a gastroenterologist.

I hope you can get it sorted soon.

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I'm definitely considering it. Thank you!

owl87

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It is known that patients with PA have low stomach acid which interferes with absorption of minerals and vitamins. It also upsets the stomach flora which leads to the symptoms you describe. I had exactly the same symptoms as you when I was diagnosed with PA. Neither my GP nor my Gastroenterologist had any idea how to treat this . Absolutely useless. Those symptoms are like IBS (Irritable Bowel Syndrome) I took a course of Symprove Probiotic , and those awful symptoms disappeared. Also acidic drinks help . Organic apple cider vinegar diluted is helpful . Also fermented foods which contain high levels of probiotics are very good - preferably organic . In difficult cases Betaine Hydrochloric Acid capsules with pectin are helpful , to be taken with a high protein meal . Look up Diet for Achlorhydria. I have to say after about a year of treatment with probiotics , my gut problems have disappeared. Hope this is helpful . .

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This is what I believed too as I also have low ferritin levels which I know is tied to low stomach acid. I will try upping probitoics - Symprove sounds interesting! Where did you get it from? I have considered the acidic drinks and acid capsules but now I'm concerned after the lemon episode yesterday. I can't understand why the lemon juice soothed bloating but apparently triggered worse burping/silent reflux/acidic taste in mouth. I've been fine reintroducing tomatoes/mild spice etc in the past couple of weeks. I did wonder if it was just the release of all the bloating or too much undiluted acid on a very damaged stomach and following after a very plain diet. Everything else suggests I have low stomach acid but yesterday's episode has thoroughly confused me as surely it would help not make it worse? Many thanks.

owl87

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Yes that lemon juice is a mystery . Of course it may be nothing to do with the lemon juice , but there’s no way of knowing . You can buy Symprove on Amazon and also health food shops

Symprove sell to you directly , with a special offer if you take the course . I have to warn you that it is expensive . But at the time I was so unwell with the bloating , burping and stomach pain , I didn’t care . Best wishes

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I've ordered some probiotic and I'm keen to give it a try! Many thanks for all the help.

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I do so hope that the probiotic will help you . But one thing , which is a blessing , even if it doesn’t work for you , it can do no harm

whatsoever , which is more than one can say for many prescription drugs . All the very best. .

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Also , I found it helped to avoid large quantities of red meat , and to eat small meals more often . Also chew well !

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Might be worth looking at Micki Rose's site - useful info plus factsheet on acid, enzymes, digestion etc purehealthclinic.co.uk/low-...

My "acid reflux" resolved after stopping eating gluten (all grains), dairy, soy, nightshades, caffeine and trying to be careful with the amount of fermentable carbohydrates - Norman Robillard's book Fast Tract Digestion, Heartburn, is interesting and I found it helpful. I can't tolerate HCl but use apple cider vinegar, more vitamin C, chew raw ginger before meals and eat foods that are easier to digest (cooked veg, some fruit, fish, a little chicken) - (I have histamine issues too and so food is complicated). Best wishes

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I think I am definitely seeing a problem when I try to up intake of startchy carbs - makes sense I suppose as with low stomach acid they just sit and ferment in my stomach. Sorry to hear about the added histamine complication for you - many thanks and best wishes to you too!

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Have you been tested for H Pylori? Worth doing so if not. I had all those symptoms and most disappeared after treatment.

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My doctor ordered a stool test - not sure if that is a test for it?

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I would think it probably is to test for that. It would be interesting to hear the outcome. It's very common but doesn't seem to affect some people as much as others.

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Yes I'm keen to see the outcome too! Thanks for the help.

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You are very welcome. Good if it's that as very treatable. Wishing you luck 😁

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I'm glad you posted about your digestion problems as I have the same. Mine pretty much come and go. I've never found anything that helps other than Tums. Did your doc tell you that you no longer have stomach acid? I'm wondering about that for myself. I tried a test of 1tsp. of baking soda in a tumbler sized glass. I don't burp or have any effect from this so I consider myself as having Achlorhydria. I know the baking soda works in making you burp because my daughter did it and Oh yes! it definitely made her burp. This isn't even close to scientific but it's enough for me. Let me know what happens if you decide to try it.

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My doctor originally prescribed a PPI over the phone but I didn't take it due to knowing b12 deficiency usually equals low stomach acid and when I went in for face to face consultation they changed their mind and told me not to take it. I have heard of the test before and I'm thinking of trying tomorrow morning just to have a better idea. I can't see how people with b12/vitamin deficiencies can have too much stomach acid when stomach acid is required to absorb them! I hope your find a solution for your problems too!

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Thank you! I suspected the same but my GI disagrees so I'll take the Creon without PPI.

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Just tried the baking soda test and didn't burp at all which pretty much confirms for me I have low stomach acid! I'm going to try the acidic drinks and probiotics others have recommended here and see if it helps at all!

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I just did the test too I did not burp.

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I think you're smarter than your doctor.

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Have a look at Micki Rose's site for more on low acid, testing, treatment options etc. purehealthclinic.co.uk/low-... (good factsheet available too). Best wishes

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Thank you, bookish

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Thank you for the info!

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I have had exactly those symptoms - burp feeling like it is stuck, some heartburn, some cramps and heartburn. I was put on Omeprazole, which is sooo wrong as it surpresses stomach acid in a gut already incredibly low (I am genetic PA). Smaller meals, not too much starch, no gluten or dairy , hardly any onion - have all helped and I do put lemon juice on anything I can.

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Thank you for the tips! It definitely seems to be a problem for many and it definitely isn't helped by ppis being first port of call! Not too much starch seems to definitely be the way for me to go - I'm beginning to notice a pattern of my problems occurring and worsening when I have upped intake.

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Definitely worth trying to sort out the stomach problems, it's only through this site I've learned so much about B12 deficiency /pa, I've had numerous problems with my stomach over the years, but ended up with various symptoms pins and needles, tingling tongue, high pitched whistling, tiredness, headaches and recently breathless, I have had duodenum ulcers, a ruptured appendix, a internal stomach bleed, ulcerative colitis, and the h pylori bug, so I didn't realise that further down the road I'd end up with B12 problems, even taking omeprazole can cause these problems, and I suffer with a skin condition which requires regular general anaesthetics, and I believe that the nitrous oxide gas can have a detrimental effect on the stomach, I'm lucky to have had a good NHS surgeon's who saved my life on two occasions, and after all that you can end up with something else, just taking a tablet to cure one problem can cause other problems, I don't drink alcohol and try and eat healthy, but you still need to enjoy life, so I'm not ruling out unhealthy food to eat,but I never realised how awful B12 symptoms can make you feel, it can affect your mindset and your mood,try and explain to your nearest and dearest how this can affect you,it's part of the upheaval you may have to face, I am on a 3 monthly cycle and also was prescribed folic acid again, after I requested a blood test as I was feeling lousy, it's important to keep on top of this sly condition as the symptoms just creep up on you, and it's a nightmare trying to get yourself motivated, I feel old before my time, good luck with any further investigations. Thanks.

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Definitely! our symptoms are very similar! I am not sure how long ago this started but a few years ago I had a severe iron deficiency despite iron rich diet and when I went on 3 months of strong meds they brought it into 'normal' range but it was still extremely low so clearly I started having low stomach acid/absorption problems years ago. I am so glad I knew not to take the PPI when they originally said it was acid reflux because I am sure it would have made me 10x worse! I know what you mean about feeling older. I am fairly young and seeing people around me full of energy advancing their careers etc when I am unable to work and feel like I can barely function is very difficult. Hoping we both find relief soon!

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I'm scared to stop the omeprazole as this was prescribed by the hospital after I suffered an internal bleed, I knew how ill I was but I brushed it aside as I had two family funeral and was ignoring the stomach, didn't have any pains really, but I'm glad that I rang the NHS 111 service as they let me know that this was an emergency, so there the predicament I'm left, even though the omeprazole can cause other problems I'd rather be on the planet a little longer, look after yourself, take care, thanks.

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I understand! Always important to rank what's best for your health based on the most pressing problems. I hope you feel better soon!

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Me too....the feeling old part. I am old but feeling old beyond my years in just the last two.

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Hello. I had the same symptoms as you, though I also had a quite disturbing cough. My problem started after the gastroenterologist I saw decided I had high stomach acid following a endoscopy I had last year. This is despite the fact that I have PA and also had an H Pylori infection at that time. . She prescribed a one month course of PPIs. About a month or so after I finished this course my problems began: stomach pain, burping, dry cough, acid reflux etc. To cut a long story short, I decided that my problem was due to low acid in stomach, not high. This was based on my own research on sites such as this, but also on common sense. I recently started a new regime to combat this which involves: chewing raw ginger three times a day; apple cider vinegar once a day; the juice of half a lime once a day (before supper). On this regime I can say honestly that I feel better. I hope this helps. I wish you all the best.

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It's interesting you mention the cough - I don't have a cough but one of the most troubling symptoms caused by my heartburn free reflux going undetected for many months is a thick post nasal drip that is very frightening sometimes. I'm trying to work out what triggers it as I managed to reduce it recently but it has come back slightly the last few days a little while after the episode I mentioned in my original post - I do wonder if the undiluted juice on my very cobblestoned throat triggered my body to send out the drip to try and coat the throat from further acid. I'm going to try the diluted lemon/lime juice and see if it helps my stomach without maybe irritating my throat because it definitely seemed to improve digestion! The ginger is also something new! Can I ask how long it took on the new regime to start seeing a difference? Thank you for the help.

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I get the post nasal drip too and it is worse if I don't dilute the lemon juice that I take each morning, so hopefully what you say about diluting will help you as well. Other things affect it too though. I also use the raw ginger - chew (really fast!) a chunk about the size of the top joint of my little finger then swallow with a little water after. I've only been doing that before my main meal but may up it to 3 x daily after reading Frank77.

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I'm sorry to hear you have it too. You've reassured me about trying the diluted lemon - trying to work out a balance between my throat needing to heal which requires me to sort my low stomach acid so the reflux will stop but getting acid to my stomach in order to do so without irritating my throat further is proving challenging! Hope you feel better soon!

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Hello again. Well I only started this regime I mentioned about two weeks ago. The results have been quite encouraging so far, though it took perhaps a week to feel the difference. The burping is better, but not gone; cough significantly improved and stomach pain almost gone. That is not to say that everything is back to normal but it is certainly better. The very least I can say is that it is not worse - which is significant considering that I was originally diagnosed with HIGH stomach acid. But if that were the case I can only assume that all the acidic stuff I take would have made the problem worse, not better... It is possible that the symptoms will never go away entirely so maybe I will have to look at some of the other good advice I have found here - eating less and more often etc. As for the post natal drip you mention - I don't have this and don't know what might cause. Best wishes to you!

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I am so glad it's working for you! I think your definitely right if it was high acid the acidic stuff would be causing you a lot of pain I'm sure! Best wishes to you too!

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