PPI + AIG

[Lhood08]

hi everyone,

I’m curious about my doctor’s recommendation to be on some type of PPI. I do have Barrett’s esophagus (which is probably the main reason he’s recommending this), but why would I take a PPI if autoimmune gastritis is already impairing my ability to make stomach acid? Wouldn’t I be trying to suppress something that is already nonexistent? I know someone mentioned in another post that somehow you can still have acid reflux (and thus develop Barrett’s) with AIG, but I’m just so confused about that.

Thanks in advance for your responses. I’m so new to all of this. I have tried taking a PPI and so far it’s made my stomach feel worse (which my doctor seemed surprised by. Whatever!).

[wedgewood]

As you have come to this forum, I’m assuming that you have Pernicious Anaemia. This means you have low or no stomach acid . Hypochlorhydria/ Achlorhydria. I don’t know how serious a diagnosis of Barrett’s Oesophagus is , but it will have been caused by acid reflux . The oesophageal sphincter fails to close tightly if stomach acid is not strong enough, and overtime the lining of the oesophagus will be damaged .

Normally , taking an acidic drink before and with food , especially protein , helps this situation . An acidic drink could be diluted apple cider vinegar , lime juice , bitters , or in severe cases a Betaine HCl with pepsin capsule .

As a P.A. patient your parietal cells, which make The Intrinsic Factor and stomach acid, will be very depleted or non existent. You need both for absorption of B12 — and stomach acid for absorption of other vitamins, minerals and trace elements.

You must take care of your stomach and eat fermented foods like real yoghurt , kefir, kimchi , sauerkraut etc. If this does not appeal , try a water based probiotic called Symprove , or probiotic tablets . This helps establish healthy gut bacteria which have a hard time existing in a non acidic stomach .A non-acidic stomach causes gut problems .

Eat smaller meals more often and , very important, CHEW THOROUGHLY , allowing the digestive enzymes in saliva to start the work of breaking down food . Relax and enjoy mealtimes

Ideally , you need an acidic environment in your stomach , and if it weren’t for your diagnosis of Barratts Oesophagus, I would be suggesting adding acid

Taking a PPI seems totally wrong . …….

But as I have no knowledge of Barrett’s Oesophagus, I’m hesitant to suggest adding acid . Definitely a good gastroenterologist ,who has knowledge about P.A.as well , is needed for advice

There are treatments for Barrett’s Oesophagus. I’ve just looked it up . endoscopic resection , Radio-frequency ablation and a procedure to tighten the oesophageal sphincter.

[Lhood08 in reply to wedgewood]

Thanks for your input! It’s so crazy to me that reflux can be caused by both overproduction and an absence of acid. I have a lot to learn!

[wedgewood in reply to Lhood08]

Underproduction of stomach acid is much more common than overproduction , but many doctors do not realise it and prescribe PPIs , which results in B12 and other vitamins and minerals being under- absorbed.

. Also , as we age we produce less stomach acid — nothing to do with P.A .

I had an acquaintance who was prescribed a PPI ( Omeprazole ) .for many years and who ended up with severe B12 deficiency causing totally numb feet and lower legs . B1 2 is the most difficult vitamin to absorb . This was irreversible. .Sufficient stomach acid is so very important to our health and well-being . . ….

[Lhood08 in reply to wedgewood]

Yep I fortunately got diagnosed before my b12 was completely depleted or else I would have been freaking out as my limbs went numb. But it does seem like gastros are just throwing around PPIs without digging deeper…it makes me a little concerned. I’m only 34 and I’m intimated by the road ahead - not only because of progression of disease, but because of the headache that doctors and testing have become. I am always wondering if I have the right team of doctors. 🫠

[wedgewood in reply to Lhood08]

PPIs are the biggest money -spinners for the Pharmaceutical Industry. They are a quick fix for what is often called “ heart burn”. ( acid reflux) Easy for doctors who don’t need to do more investigating . Nice for patients to get rid of pain . . But it means that vitamins and minerals are not absorbed fully . PPIs should only be used for a short time , but are often used for many years .

[charks]

Have you tried altering your diet. I used to have terrible acid reflux which was very painful. As soon as I gave up gluten and dairy it stopped and hasn't returned.

[Lhood08 in reply to charks]

Yes, as I’ve changed my diet, things have slightly improved so far. I’ve been following something similar to FODMAP

[Nackapan in reply to Lhood08]

My daughter did that.Took many months to work it all out.

Made a huge difference with reflux and digestion.

Certain foods she can eat but in small portions.

She's recently started reintroducing foods.

Egg in things first now able to eat egg .

That's after yesrs though of improving her gut health and digestion.

Almond milk fortified and avocado her initial savour

With maize snacks as she needed more salt.

I experimented making all sorts to help.

Lentils in tins fir example tolerated better than cooked from raw.

Something released into the water.

Gets very complex but well worth the effort .

[Sailinglady]

The reason your doctor wants to prescribe a PPI is because Barrett's oesophagus is a precursor to oesophageal cancer (i.e. a pre-cancerous state). Not dangerous in and of itself, but if allowed to progress to cancer, obviously is.PPIs have evidence to show they reduce the risk of progressing to oesophageal cancer. I can't comment on whether you still have stomach acid or not, but if I were you, I would want to be absolutely certain I didn't need them before stopping them. Even if it did mean taking B12 supplements to counteract their effects.

[boisland]

Lhood08 Acid is not the only culprit, below link suggests Barrett’s oesophagus may originate even in a hypochlorhydric patient, strengthening the hypothesis that acid is "not" the sole culprit of oesophageal damage. Just sharing what I have learnt: If it made your stomach feel worst perhaps suppressing what acid you do have is causing more gastritis, due to:1) Reduced acid strength allowing the proliferation of bacteria, parasites, and pathogens in the digestive tract. 2) Inadequate digestion due to reduced acid can cause indigested foods particles to develop a sensitivity or create irritation. 3) delay stomach emptying due to low stomach acid known as gastroparesis can cause gastritis.. The autoimmunity itself will cause gastritis. You did not mention the symptoms you were experiencing but shared what I thought might help. Good luck finding a GI that understands this condition. ncbi.nlm.nih.gov/pmc/articl....

[Lhood08 in reply to boisland]

Thanks!! This is great. All 3 of those things describe my experience. I sense that my GI does not grasp that there are other culprits besides excess acid 😭