Parietal cell regeneration

[Chickens44]

I think my B12 deficiency is due to malabsorption. Possibly from taking omeprazole for 20 years. I am addressing my deficiencies with all cofactors, but my question is if omeprazole damaged my gut parietal cells, will they regenerate or are they damaged permanently? I cant seem to find a definitive answer.

[wedgewood]

Omeprazole will not have damaged your parietal cells . Omeprazole is a Proton Pump Inhibitor . It will have neutralised the stomach acid that is produced by the parietal cells . Stomach acid is needed to break down food to enable it to be absorbed. Intrinsic Factor alone is not enough . Having taken omeprazole for 20 years will have had a very bad effect on your ability to absorb B12 ( and other minerals and vitamins .) You really need an extended course of b12 injections , probably every other day , until you have no more symptoms of B12 deficiency in . Not forgetting a modest daily 400mcg tablet of folic acid …

If you cannot manage without Omeprazole , you will need to continue to have B12 injections for as long as you are taking it .

Of course , there is always the possibility that you have Pernicious Anaemia , and if this is the case , you will need B12 injections for life

If your GP does not oblige, consider self Injection . b12 ampoules are easily obtainable from excellent German Online Pharmacies . Not too expensive ,about £2.00 for an injection , including needles and syringes . You can get all the information that you need from members on this forum . Best wishes .

[Chickens44 in reply to wedgewood]

I’m am on B12 Si EOD and have been since end of May, with cofactors. I don’t appear to have autoimmune gastritis which is good. My query was if PPis had damaged my parietal cells, whether my gut will recover from long term use of PPIs. Which I think you have probably answered. I am having good probiotics, ACV, good kefir and following a healthy eating plan. Was just concerned my gut wouldn’t recover.

[Technoid in reply to Chickens44]

I was able to find a letter to a gastroenterology journal which made some interesting statements on this.

"We have shown that parietal cell hypertrophy and hyperplasia occur secondary to omeprazole therapy and that the greater the length of time the patient receives omeprazole, the greater the changes."

...

"Patients who stop taking proton pump inhibitors (PPIs) experience increased symptoms of gastroesophageal reflux disease (GERD), likely related to rebound acid hypersecretion. It is reasonable to postulate that rebound acid hypersecretion after cessation of PPI therapy is directly related to increased acid output from hyperplastic and hypertrophic parietal cells.

Although the parietal cell abnormalities appear to be reversible after cessation of therapy, questions remain regarding the long-term effects of the drug on parietal cells and the natural history of omeprazole-induced fundic gland polyps in the face of persistent and long-term therapy."

from gastrojournal.org/article/S...

[Chickens44 in reply to Technoid]

Thanks. Very interesting. I stopped the omeprazole last Christmas and didn’t have rebound reflux after stopping. But I don’t think I ever did suffer with acid reflux, I think my GP originally put me on them for IBS.