PPI’s

[lifegems]

Just a further quick update and question please folks. I had the results back from my polyectomy (encouraged to go for endoscopy and colonoscopy by you guys and thank goodness I did) it was one step away from being cancerous! The dr was the first medical professional I’ve ever seen whom understood about PA and confirmed I have the autoimmune atrophic gastritis which I assume is causing the pain in my stomach and said there is nothing that can cure it only management and gave me a PPI acid reducing medication but I thought low acid was part of the problem ? She was reluctant for me to take it and I’m not really sure why ? Any feedback gratefully accepted!

[fbirder]

Obviously the doc doesn't totally understand PA. Otherwise they would know that it destroys the cells that make stomach acid. So the PPI isn't likely to do much at all.

What she said about nothing to cure it is correct. Many people, me included, find that drinking a small amount of acid during the last half of large meals can help enormously with the symptoms. I use about 30 ml of lime juice (in water or fizzy orange) and others swear by apple cider vinegar.

When they said that the polyp was one step away from being cancerous, I assume they meant that they found signs of metaplasia but not hyperplasia. Metaplasia is the norm for people with PA.

When you have PA you don't make stomach acid. This causes many problems (a lot of which are very similar to having too much acid). One of them is hypergastrinaemia.

When you eat something your body makes the hormone gastrin. This (amongst other things) stimulates your parietal cells to make acid. This acid lowers the pH of the stomach - which switches off gastrin production.

If you have PA then your immune system kills the parietal cells, so you don't make acid, so the pH of the stomach stays high and gastrin production doesn't get switched off. You get too much gastrin in the blood (hypergastrinaemia).

One of the other effects of gastrin is to stimulate the production of things called ECL cells. When you have PA your stomach lining has no parietal cells, but lots of ECL cells. This is called metaplasia (having too many of the wrong cells). It's not bad in itself. This is, I suspect, the stage your polyp was at. And the stage most people with PA will be at.

Sometimes this stimulation for extra growth gets slightly out of control and you get hyperplasia. At this stage the cells for what used to be called a gastric carcinoid but is not called a Neuroendocrine Tumour (NET).

That is the stage my stomach is at.

NETs are rare (I've only encountered one other person with them) and they aren't much to worry about. My treatment is for the docs to look at them every two years to make sure they are sitting quietly doing nothing.

Here is a good article about gastric carcinoids and how they come about. onlinelibrary.wiley.com/doi...

[lifegems in reply to fbirder]

Hi Fbirder thank you so much for such a comprehensive reply which I need to re read and absorb .. but the polyp which was the problem was in the Colon not the stomach which I assume is different from what you are saying ? There was one in the stomach but that was benign.. the one in the colon was v large and had high grade displasia (not sure of spelling) but basically cells that were turning cancerous or would do eventually.. I asked about the acid in the stomach and she gave me a comprehensive response but I guess I didn’t take it in.. I’m so confused 😐 so I’m guessing from what you have said something like apple cider vinegar etc would be better than the PPI ?

[fbirder in reply to lifegems]

Ah!

I remembered the stomach one, not the colon one.

Yes, dysplasia (where the cells themselves look 'wrong') is a precancerous state. As is hyperplasia (where the cells look normal but there are too many of them). Both dysplasia and hyperplasia can become cancerous.

I would try taking some apple cider vinegar and see how it goes. Add about 25 mL to a glass of water. Start drinking it halfway through a meal and make it last until the end.

[lifegems in reply to fbirder]

Thank you ! I will try this.. 😁