Pancreas causing B12 deficiency?

[Luac]

All my test results from gastroenterologist were complete just before Christmas but Im frustratingly still waiting for him to get in touch despite having called his office several times. I was referred with suspected malabsorption issues including B12 deficiency and bowel trouble.

Colonoscopy and biopsies were fine.

Urine test was fine.

CT scan was fine.

Endoscopy showed gastritis, oesephagitis and a hiatus hernia. Omezaprole was prescribed for two months. That course has finished.

Stool sample showed low faecal elastase (124 or so).

A reaction to alcohol has worsened in past six months coinciding with worsening bowel issues. If i drink, my face gets very red and hot very quickly with other sinus type issues - very bunged up, mild swelling. The redness and swelling go fairly quickly too.

My blood pressure also went high about seven months ago and I am on ramipril. I'm 42 years old.

I am beginning to suspect this is all related to some enzyme problem.

Would an enzyme/pancreas issue cause the B12 deficiency and the reaction and the tummy issues? Are these connected or not?

I havent had a PA test, folate is fine.

Should I be asking about low stomach acid?

Im just really fed up waiting. Is it worth going private in the UK?

[Nackapan]

I've paid. Same doctors just seen more quickly. Separate clinic sessions s so not queue jumping ad such.

I like you was waiting for a result to be read and explained. Brain mri. Neurologist wait to do this was yo to 18 weeks!

It was worth paying g to reduce the stress. I was seen the day I rang. Never paid before but have 3 times now. I was actually discharged by nhs one !!

I've also paid for pysio as my first nhs one was 30/12 and keep being cancelled since by them. So still waiting g.

Costly business.

[Hidden]

I suggest you get your fecal elastase tested. You GP can do this. The test is very sensitive and therefore accurate. There’s no scientific evidence I have been able to find that suggests reduced pancreatic function caused B12 deficiency however a number of people with PA have reduced pancreatic function. It is called exocrine pancreatic insufficiency (EPI). I have that and if you have it you must fix it.

[Luac in reply to Hidden]

Hi Martin, it was tested and came back low - 124.

I have been told I need to get it tested again just to make sure, but I dont know about that given GP's being keen to retest B12 unnecessarily.

I found this:

A malabsorption of vitamin B12 is observed in about 30% of adult patients with exocrine pancreatic insufficiency, using the Schilling test. None of the hypotheses that have tried to explain this malabsorption are entirely satisfactory. A failure to degrade haptocorrin can prevent the binding of vitamin B12 to intrinsic factor. It has also been suggested that pancreatic secretion could modify the structure of intrinsic factor, enabling the uptake of the vitamin B12-intrinsic factor complex by the ileum.

ncbi.nlm.nih.gov/m/pubmed/2...