Can pernicious anemia cause sudden, severe diarrhea?

[Hedgehog235]

Hi everyone, very recently diagnosed with P.A. and have had 7 injections so far (hydroxoco, 1mg). For weeks before I started the injections, and for a while after the first couple, I suffered with mild diarrhea. Very recently, there was a gap of nearly two weeks between my injections (I developed a bit of needle fear which took me a while to work through), and in that interval the diarrhea has come back, which I don’t find surprising or concerning. My last injection was two days ago after this 11 day gap.

What I’m now concerned about however is that today my diarrhea has, out of nowhere, become much more severe. Obviously I know P.A. isn’t the only possible cause of this and I’m seeking medical advice to rule out other causes, but is it possible for P.A.-related diarrhea to abruptly get much worse without warning? Thanks.

* I have read that folate deficiency can cause diarrhea too - I stopped taking this for five days during my 11-day injection gap (I.e until the day before yesterday), as I have read that taking folate without B12 is not a good idea (have resumed taking it for the last 3 days since I had my injection) - could this possibly be the cause?

[clivealive Forum Support]

Hi Hedgehog235 The gastrointestinal symptoms of vitamin B12 deficiency may include:

 A sore tongue

 Appetite loss

 Diarrhoea and/or constipation

 Stomach pain

Do you know what you folate level is at the moment?

I am not a medically trained person but have had P.A. for over 48 years

I wish you well

[Hedgehog235 in reply to clivealive]

Hi Clive, thanks for your reply! Unfortunately no I don’t know my folate level - going to ask to have it tested next time.

[clivealive Forum Support in reply to Hedgehog235]

Folate, iron and B12 work together to make red blood cells

Goodnight from the U.K.

[Hedgehog235 in reply to clivealive]

thats really helpful to know! Thank you

[Madison659]

I have found that there can be many changes to my bowel habbits with the injections. Also it can depend on what foods tou eat while having the needles say steak and broccoli can make diahorea worse for me.

[Hedgehog235 in reply to Madison659]

It’s really interesting to know that injections can effect your bowel habits, thanks for your reply - do you find the effects of the injections on your digestive system to be quite unpredictable then?

I also had no idea the food you eat the day of the injection could play into things! I’m learning so much from this forum

[fbirder]

Keep a food diary. Keep a log of what you eat and what symptoms you have. After a while you may notice that certain symptoms follow eating certain foods. Using this method I found that I had an intolerance of foods containing fructose and fructans. Some other FODMAPS, in large amounts also caused problems.

Fructose is the worst. If I drink 500 mL of Fever Tree naturally light tonic water then, 8 hours later I am sitting on the toilet for four hours.

[Hedgehog235 in reply to fbirder]

It hadn’t occurred to me I might have food intolerances, having had a coeliac test come back negative - I’ll have to start being more vigilant!

[fbirder in reply to Hedgehog235]

There are a lot more people sensitive to FODMAPS than there are coeliacs. Studies have shown that people who think they have non-coeliac gluten sensitivity are actually sensitive to FODMAPS. I’ll post the research tomorrow (I can’t find it on my iPad, need laptop).

[fbirder in reply to fbirder]

In 2013, a study of non-coeliacs who ate gluten-free to relieve gut issues found no difference in symptoms when these people ate identical meals that either lacked gluten, or were full of it. This suggested gluten has no effect, prompting Jane Muir and Peter Gibson at Monash University in Australia and their team to wonder if there might be an alternative culprit.

They suspected fructans, which are a type of sugar chain found in wheat, barley and rye, as well as onions, garlic, chickpeas, cabbage, and artichokes.

To test this, they recruited 59 non-coeliac adults currently following gluten-free diets for gut sensitivities. They gave these volunteers three types of cereal bars containing gluten, fructans, or neither, and the participants ate one of these every day for seven days, with week-long spaces in-between each type of bar. The bars all looked and tasted the same, and the participants did not know which ones they were eating.

The fructan bar triggered 15 per cent more bloating and a 13 per cent increase in overall gastrointestinal symptoms, compared to the control bar. The gluten bar, however, had no effect.

This may explain why people with irritable bowels often improve on gluten-free diets but don’t make a full recovery, says Muir. By cutting out wheat, they eliminate a large portion of fructans from their diets, but they can still run into trouble eating other high-fructan foods like onions and garlic. Some gluten-free products like chickpea crisps also contain fructans.

It may also explain why few placebo-controlled studies have managed to find that gluten has any effect, and why it has been so difficult to find out how gluten may cause problems for non-coeliacs, says Gibson.“Gluten was originally assumed to be the culprit because of coeliac disease, and the fact that people felt better when they stopped eating wheat,” he says. “Now it seems like that initial assumption was wrong.”

Read more: newscientist.com/article/21...

[Kate1914]

welcome to the club.....

[Cherylclaire Forum Support]

On my first appointment with GP in 2015, I remember complaining mainly of fatigue, hip pain and diarrhoea. I was found eventually to have B12 deficiency, low ferritin and folate and osteopororsis of the spine. Later, due to a poor response to B12, an MMA test revealed functional B12 deficiency. Extensive tests showed nothing much else.

Over the following years, I was sent to gastroenterologists- who all said IBS. I was also sent to a dietitian - who put me on a low-FODMAP diet for 3 months. This did not change anything for me. It makes no difference at all what I eat or don't eat.

It took me a couple of years to sort out my folate and ferritin problems completely - to have results in the top 1/3 of ranges and remain there.

Most of the B12 symptoms that I had have got better, more manageable and some have become rare. There are some more stubborn symptoms: burning tongue and diarrhoea being the most consistent. They remain daily, despite frequent injections.

We are thankfully all different - but yes, B12 deficiency can cause this and you are right about folate too. If you haven't already been tested, I would ensure that you get a blood test for folate, ferritin, vitamin D and thyroid. The NHS rarely test full panel thyroid, so you might choose to do this via postal blood test.

Quite often, people here find that symptoms can get worse before better as the body adjusts. Don't get disheartened by this. You are also right in thinking this could have a number of causes. Many GPs would not necessarily connect this problem with B12 deficiency- they seem to be working with a far shorter symptoms list !

Stay well-hydrated, Hedgehog - and go back to your GP if this remains severe.