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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Pernicious Anemia, Taken Spastic Duodenal Cap, Taking B12 Shot. Suggestion?

I have a spastic duodenal cap. In 2004, I was told that I had pernisious anemia that developed over three years. My stomach can t absorb vitamin B12 anymore. I will need a B12 shot every three to four weeks the rest of my life. I know that when we get older, our physical and medical conditions deteriate. I suspect that the past scarring of my stomach from my ulcer , plus my age(63) is a direct cause of my enability to absorb B12 through my stomach. Can you give me any confirmation on this matter? Sincerely, E. H. Greene, 4/17/2012
Tue, 1 Apr 2014
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Ayurveda Specialist 's  Response
**
1. since you are giving a long history of ulcer, thus apart from scarring 'pyloric stenosis' is also possible, thus analysis of gastric aspiration and Barium meal X-ray of stomach and duodenum is essential.
2. since Pernicious Anemia [PA] is an AUTOimmune disorder i.e. the body’s immune system attacks and destroys the stomach’s mucosal cells: as a result Intrinsic Factor [IF] can no longer be made, and vitamin B-12 cannot be absorbed, so scarring at most will cause gastric outlet obstruction [which can narrow or close the intestinal opening and can prevent food from leaving the stomach and entering the small intestine,resulting in vomiting the contents of the stomach]
3. In old age [63], as there is atrophy of the glandular mucosa of the fundus of the stomach which is same etiology of pernicious anemia, thus AGE is a contributory factor for the progress of the disease.
4.
.Take: bland diet,rice with plain dal,boiled vegetables,sweet biscuits,sweet fruits,plain idli.
.avoid sour fruits like citrus fruits,imli,grapes,instead take sweet/dry fruits.
.avoid all chillies.
.avoid period of starvation:take small meals every 2 hrs.
.do not keep the stomach empty,also don’t take heavy meals.
.avoid tea and coffee.milk is good (cold)
.for breakfast and snacks:bread/toast jam,cheese or butter,cornflakes
.avoid deep fried and hot foods.
.eat food which are low in fats.
.eat at a leisurely pace.chew your food well.
.avoid eating 3 hrs prior to retiring to bed.may cause secretion of gastric acid if meals taken during bed time.
.include protein in each meal and snacks.
.antacids are the drug of choice.


PS.
.avoid gastric irritant drugs like aspirin,all NSAID’S,steroids.
. complication of PA is severe neurological deficit, thus regular Neurologist Opinion is must.
. diet rich in vitamin B12 are: liver, beef/mutton;chicken,fish,whole egg, milk, cheese, yogurt.
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Had Pernicious Anemia, Taken Spastic Duodenal Cap, Taking B12 Shot. Suggestion?

** 1. since you are giving a long history of ulcer, thus apart from scarring pyloric stenosis is also possible, thus analysis of gastric aspiration and Barium meal X-ray of stomach and duodenum is essential. 2. since Pernicious Anemia [PA] is an AUTOimmune disorder i.e. the body’s immune system attacks and destroys the stomach’s mucosal cells: as a result Intrinsic Factor [IF] can no longer be made, and vitamin B-12 cannot be absorbed, so scarring at most will cause gastric outlet obstruction [which can narrow or close the intestinal opening and can prevent food from leaving the stomach and entering the small intestine,resulting in vomiting the contents of the stomach] 3. In old age [63], as there is atrophy of the glandular mucosa of the fundus of the stomach which is same etiology of pernicious anemia, thus AGE is a contributory factor for the progress of the disease. 4. .Take: bland diet,rice with plain dal,boiled vegetables,sweet biscuits,sweet fruits,plain idli. .avoid sour fruits like citrus fruits,imli,grapes,instead take sweet/dry fruits. .avoid all chillies. .avoid period of starvation:take small meals every 2 hrs. .do not keep the stomach empty,also don’t take heavy meals. .avoid tea and coffee.milk is good (cold) .for breakfast and snacks:bread/toast jam,cheese or butter,cornflakes .avoid deep fried and hot foods. .eat food which are low in fats. .eat at a leisurely pace.chew your food well. .avoid eating 3 hrs prior to retiring to bed.may cause secretion of gastric acid if meals taken during bed time. .include protein in each meal and snacks. .antacids are the drug of choice. PS. .avoid gastric irritant drugs like aspirin,all NSAID’S,steroids. . complication of PA is severe neurological deficit, thus regular Neurologist Opinion is must. . diet rich in vitamin B12 are: liver, beef/mutton;chicken,fish,whole egg, milk, cheese, yogurt.