Gastric atrophy ??: Now as I’m still... - Pernicious Anaemi...

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Gastric atrophy ??

Narwhal10 profile image
14 Replies

Now as I’m still new and trying to learn please may you add to my knowledge and correct anything I have misunderstood.

I had a positive coeliac blood test, I’m not doing the gluten challenge and biopsy because this has gone on for over 20 years and I’ve put up. So now I have started ferrous fumarate and loading doses of B12 every other day (I’ve neuro symptoms) but I would like to know the state of my GI tract as nausea, dyspepsia and the delightful and attractive retching. I’m happy to go private for gastroscophy and blood tests pepsinogen I, II, I/II, fasting gastrin and H pylori. Anything else ? I would like to rule out achlorhydria.

I’m not bothered to have a diagnosis of PA (autoimmune meta plastic atrophic gastritis) or vitamin B deficiency - same management, symptoms. What I would love is quality of life. 😊

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Narwhal10
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14 Replies
Nackapan profile image
Nackapan

Hope it gives you some needed answers

Narwhal10 profile image
Narwhal10 in reply to Nackapan

Thank you

Narwhal10 profile image
Narwhal10 in reply to Nackapan

Thanks Nackapan

fbirder profile image
fbirder

As GP for a referral to a gastroenterologist. They will almost certainly offer a gastroscopy. If GP reluctant say you're worried about gastric neuroendocrine tumours.

ncbi.nlm.nih.gov/pmc/articl...

Narwhal10 profile image
Narwhal10 in reply to fbirder

Thanks fbirder,

My GP is pretty receptive and I’m going to go private. I’m not overly concerned about NETs. I understand from your posts that you have a degree in chemistry. 👍🏻

One of my particular interests for my own health is the relationship between gluten, glutamate and GABA. 😉

fbirder profile image
fbirder in reply to Narwhal10

Yes, you're right not to be concerned about NETs, but it would have been a good reason to give to a reluctant GP. As yours is good then you won't need it.

I have no real idea about anything to do with gluten or coeliacs as I don't have a problem with gluten at all. Indeed, most people who say they have non-coeliac gluten sensitivity don't.

Here's an article from New Scientist. It may be behind a paywall, so I've extracted the relevant bit. newscientist.com/article/21...

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.”

By keeping a food and symptom diary I found that I have a sensitivity to fructose and fructans. Fructose has the most definite effect (waking me up at 04:00 - if I'm lucky) in the smallest amounts. Fructans are OK in small doses (like 1/8th of an onion - 1/4 wil have nasty effects)

bquoss profile image
bquoss

Narwhal10, I have had significant improvement in gastro symptoms since I began taking Celebrex/celecoxib for arthritis. It is an anti- inflammatory prescription-level medication. I believe antibodies attacking the stomach lining create inflammation, so perhaps the celecoxib is reducing that inflammation. For me, dyspepsia and other more unpleasant symptoms are reduced (not gone), and I can eat more foods. However, this medicine is often avoided for creating serious gastric problems. I am not recommending it, just reporting the results I have had. I did ask on this forum about taking celebrex, but got minimal responses. Perhaps this will bring more.

Narwhal10 profile image
Narwhal10 in reply to bquoss

Thank you for your reply.

That’s good that you have found something that is helpful.

All the best.

fbirder profile image
fbirder in reply to bquoss

Yes, Celebrex is an NSAID and can cause gastritis. You may be swapping short-term relief for long-term damage.

bquoss profile image
bquoss in reply to fbirder

Thank you, fbirder. I did research and weighed the costs/benefits before trying it for a limited period. The ratio of benefits then outweighed possible costs, as the improvement was so dramatic. But I am 84 and put a lot of weight on quality of daily life for time remaining. The costs for a younger person should be higher. I found only one study (sorry, don't have cite), with animals, and it was not long-term. Still, my experience indicates that the inflammatory aspect of autoimmune gastritis could be a path for useful research.

fbirder profile image
fbirder in reply to bquoss

I can tell you, from personal experience, that large doses of ibuprofen only had adverse effects on my stomach.

bquoss profile image
bquoss in reply to fbirder

True of ibuprofen, which is both Cox-1 and Cox-2 inhibitor, while celecoxib is cox-2 only, developed to avoid the gastric problems from Cox-1. I think there are still risks and don't want to minimize them.

helvella profile image
helvella in reply to fbirder

I cannot but agree! The thing that is sometimes missed is that stomach issues occur not just with tablets but also with things like ibuprofen gel. At the time, I had not realised this was the case and used a gel for tennis elbow.

fbirder profile image
fbirder in reply to helvella

Me too.

I used to suffer horrendous arthritis and thought I was being smart by using ibuprofen gel. Then my gastroenterologist told me that I wasn't.

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