Autoimmune Atrophic Gastritis and Pernicious Anemia diagnosis

[ReallyWondering]

I was just diagnosed with AIG in addition to the PA. Apparently, the AIG caused the PA. My only symptoms were constant heartburn, exhaustion, hair loss, and pins and needles in my feet. Since injecting weekly for three months then EOD (against doctors orders) for two weeks, the pins and needles are now just a light tingling and the exhaustion and hair loss stopped. I’m going to start spacing out the injections. However, I still have terrible heartburn and discomfort in the middle of my breast bone. The GI says I don’t have acid reflux, although I been treated for that for the last 6 years with PPIs. They stopped working. H2 blockers not working either. I’m assuming I now have low acid from the AIG. Liquid gaviscon does help, but I have a feeling it’s just masking the symptoms. Does anyone else have this issue? Any ideas how to stop it?

[charks]

I had that. Stopped eating dairy and gluten and never get acid reflux now. I think AIG makes it very hard for the gut to handle dairy and gluten.

[ReallyWondering in reply to charks]

How long did it take for you to notice a difference?

[charks in reply to ReallyWondering]

Within a week. I also was very bloated and that went away. And over the next couple of months I lost over 2 stones in weight. Which has stayed off.

[Hockey_player]

A wedge pillow or elevating your bed will help at night. It also helps to avoid eating (or eat only a little) late at night.

[ReallyWondering in reply to Hockey_player]

I don’t have issues at night, only during the day.

[MindfulSquirrel]

I found that stopping gluten and lactose helped (gluten with the gastro stuff, lactose has more helped with migraines). Also a short period on HCL tablets seems so have increased my acid production again, although I think you have to be careful with starting it if you’ve got actively symptomatic gastritis at the time.

[ReallyWondering in reply to MindfulSquirrel]

Why would taking HCL be an issue with AIG?

[MindfulSquirrel in reply to ReallyWondering]

Because if it’s all inflamed already then it can irritate things further, I assume?

I’m back on them btw. I thought they were creating discomfort but I think it might have just been premenstrual reflux.

[J972]

Have you stopped the PPIs?

[ReallyWondering in reply to J972]

Yes, months ago. Only using gaviscon as needed.

[J972 in reply to ReallyWondering]

Good x

[Cornwaller]

I found that avoiding gluten, especially bread, pastry and cakes, helped and I didn't need to totally avoid every trace of gluten - but I realise we are all different. I found eating raw cabbage with oats each morning helpful. I think there is something in raw brassicas which is soothing and it's a thing in Japan but seen seen as a bit weird here!

[ReallyWondering in reply to Cornwaller]

I tried drinking cabbage juice for five days and there was no difference.

[Cornwaller]

Sorry to here that. Best wishes.

[carr_trip]

I'm curious how they diagnosed you with AIG ? I was told I had "gastritis" (I'm in the US) but negative for H.pylori, so I've been curious to learn more about this connection between AIG and PA and was wondering how I could get my gastroentero doctor to test further, and determine if there was low acidity. (their only suggestion was to avoid NSAIDS, fatty foods, and then to take PPIs)

[ReallyWondering in reply to carr_trip]

Report from GI:

Esophageal biopsies show no concerning reflux complications.

Stomach polyp was a benign hyperplastic polyp.

Stomach biopsies confirm the autoimmune atrophic gastritis we discussed. You also had a finding called "intestinal metaplasia" which we'll need to keep an eye on every 3 years or so.

I asked about a low acid test and she said I’d have to keep a tube in my nose and down my throat into my stomach for 24 hours. It’s the only way they can test it. I declined. I assume I have low acid. I was told I could eat whatever I want, unless it bothers me. Right now I’m taking gaviscon after every meal and it’s keeping the heartburn at bay.

[ReallyWondering in reply to carr_trip]

I was also negative for h. Pylori, and the AIG caused the PA. First the parietal cells went, then the intrinsic factor cells. That’s the normal progression of this autoimmune disease.

[firehill]

Has the cause of the AIG been diagnosed? If it is autoantibodies to the parietal cells in your stomach then you will experience a gradual decline in gastric acid production as these cells are responsible for the secretion of stomach acid. This affects the action of the lower esophageal sphincter which normally closes in response to the raised level acid when you eat, preventing reflux. However with reduced acid production the response of the sphincter is reduced and it doesn't close as effectively, hence the feeling of reflux.

As mentioned above supplementation with betaine HCL at mealtimes is pretty much the standard way to go here.

Antacids/PPIs are likely the opposite of what you need as they further reduce/inhibit the production of gastric acid.

[ReallyWondering in reply to firehill]

Thanks for that explanation. I’m not sure what you mean by cause? I already had hashimotos, and it’s common to have more than one autoimmune disease. The stomach biopsy confirmed the diagnosis. I assume I have low acid because the PPIs and H2 blockers stopped working. The gaviscon is helping for now. I will look into the betaine HCL. Is there a particular brand you would recommend? I’m in the US.

[firehill in reply to ReallyWondering]

The cause is moot I suppose then as the biopsy confirmed the AIG. AIG is the eventual result of the destruction of the stomach's parietal cells caused by autoantibodies to those cells. There's plenty more detail here: ncbi.nlm.nih.gov/pmc/articl...

I find betaine HCL capsules to be more effective that tablets, for example these work well and are available in the US: uk.iherb.com/pr/doctor-s-be...

And if you are inclined this is my referral link: iherb.com?rcode=HVB704