Atrophic gastritis during long‐term omeprazole therapy affects serum vitamin B<sub>12</sub> levels

Schenk, B.E.; Kuipers, Ernst J.; Klinkenberg‐Knol, Elly C.; Bloemena, Elisabeth; Sandell, Maria I.; Nelis, G. F.; Snel, P.; Festen, H. P. M.; Meuwissen, S. G. M.

doi:10.1046/j.1365-2036.1999.00616.x

Cited by 49 publications

(34 citation statements)

References 7 publications

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“…It is possible, therefore, that an underestimation of mild-moderate atrophic gastritis would underestimate the burden of atrophic gastritis on serum vitamin B 12 in older people. Further, it is likely that atrophic gastritis precedes vitamin B 12 deficiency and that vitamin B 12 deficiency may eventually manifest itself in these people over time (Schenk et al, 1999), a relationship that would not be apparent from cross-sectional survey data. A downward trend in serum vitamin B 12 concentrations over a mean period of 4 y has been reported in people with chronic atrophic gastritis (Wood et al, 1964).…”

Section: Discussionmentioning

confidence: 99%

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

et al. 2004

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Objective: To determine the serum vitamin B 12 status of older New Zealanders and to assess the impact of atrophic gastritis on vitamin B 12 status. Design: A cross-sectional nationally representative population-based survey. Method: Serum vitamin B 12 concentrations were used to assess vitamin B 12 status. The presence and severity of atrophic gastritis was classified using serum pepsinogen I and II. Subjects: A total of 466 noninstitutionalized urban and rural dwelling New Zealanders aged 65 y or older who participated in the 1997 National Nutrition Survey. Results: The prevalence of deficient (o148 pmol/l) and marginal (148-221 pmol/l) serum vitamin B 12 concentrations was 12 and 28%, respectively. The prevalence of atrophic gastritis was 6.7% (severe 3.1%, mild-moderate 3.6%). While atrophic gastritis increased the relative risk (RR, 95% CI) of having a deficient or marginal serum vitamin B 12 concentration by 21-fold (6-67) and five-fold (1-17), respectively, those who had atrophic gastritis made up only 33 and 6% of the participants with deficient or marginal serum vitamin B 12 concentrations. An intake of vitamin B 12 from food that exceeded the recommended dietary allowance (2.4 mg/day) did not protect against deficient (RR 0.5; 95% CI: 0.2, 1.2) or marginal (RR 0.9; 95% CI: 0.5, 1.7) serum vitamin B 12 status. Vitamin B 12 supplement users had a reduced risk of having deficient and marginal vitamin B 12 status (RR 0.3; 95% CI: 0.1, 0.8).Conclusions: There is a relatively high prevalence of deficient and marginal serum vitamin B 12 concentrations among older New Zealanders. However, the prevalence of atrophic gastritis was low in the New Zealand elderly compared with other surveys. Although atrophic gastritis was a risk factor for low vitamin B 12 status, it did not fully explain the prevalence of low serum vitamin B 12 .

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Section: Discussionmentioning

confidence: 99%

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

et al. 2004

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“…Finally, the observation of H. pylori-infected pediatric patients with atrophy and intestinal metaplasia is exceedingly uncommon. Pathologic diagnosis of atrophy has been controversial in adult populations because of the lack of strict diagnostic criteria, difficulties in performing the diagnosis in one biopsy, and poor reproducibility when assessing severity (14,16,32,33). Clearly, prospective studies with larger numbers of children from multiple centers and geographic regions are needed to better define the spectrum of illness and natural history of disease following pediatric H. pylori infection, as well as to better understand the epidemiology and pathobiology of this infection; such studies are essential for developing more effective methods of eradication and prevention.…”

Section: Discussionmentioning

confidence: 99%

“…In these centers, biopsies (ca. 0.1 to 0.2 mg/biopsy) were homogenized under aseptic conditions in either 1.5 ml of sterile saline or transport medium (vial containing 1.5 ml of brucella broth and 20% sterile glycerol) and a loopful of homogenated biopsy tissue streaked onto both nonselective (brain heart infusion [BHI] agar with 5% sheep blood) and selective (Skirrows) media using previously described techniques (31)(32)(33). Briefly, agar plates were placed under microaerobic conditions (5% O 2 , 10% CO 2 , 85% N 2 ) at 37°C and incubated for 5 to 10 days until small, gray, translucent colonies consistent with the morphology of H. pylori were obtained.…”

Section: Methodsmentioning

confidence: 99%

Genotypic, Clinical, and Demographic Characteristics of Children Infected with Helicobacter pylori

Gold

Doorn

Guarner³

et al. 2001

J Clin Microbiol

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Helicobacter pylori isolates vary between geographic regions. Certain H. pylori genotypes may be associated with disease outcome. Thirty-eight children underwent diagnostic upper endoscopy at four medical centers and were retrospectively analyzed to determine if H. pylori virulence genes were associated with endoscopic disease severity, histologic parameters, and host demographics. The H. pylori virulence genotype was analyzed by a reverse hybridization line probe assay and type-specific PCR. Endoscopic ulcers or erosions were found in 17 (45%) patients, with 13 (34%) of these patients having antral nodularity. Histological gastritis, of varying severity, was present in all children. Four patients harbored more than one H. pylori strain: one subject had both cagA ؉ and cagA-negative strains, while three patients harbored either two different cagA-negative strains (two children) or two cagA ؉ strains (one child). There were 28 (74%) cagA ؉ isolates; 19 were associated with the vacA s1b genotype, 7 were associated with the vacA s1a genotype, 1 was associated with the vacA s1c genotype, and 1 was associated with the s2 genotype. Of 14 cagA-negative isolates, 6 were vacA s2 genotype, 4 were vacA s1b, 3 were vacA s1a, and 1 was vacA s1c. Nine of ten (90%) Hispanics had similar H. pylori strains (vacA s1b,m1), and all Asian-Canadian children were infected by strains with vacA s1c genotype. No correlation between H. pylori strain and endoscopic or histopathologic abnormalities was found. This study provides a baseline framework of North American children and their H. pylori strains, serving as a powerful epidemiological tool for prospective investigations to better understand the transmission and evolution of diverse disease outcomes.

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“…Many studies have shown that also PPIs used long term in non-elderly patients do not reduce seriously serum vitamin B12 concentrations and therefore body B12 stores. [58][59][60][61][62][63] Thus, a significant reduction in serum vitamin B12 levels and a serious anaemia seem possible only in elderly patients with gastric atrophy 54,64,65 and in patients with ZES, who need a long-term therapy at very high dosage.…”

Section: Vitamin B 12mentioning

confidence: 99%

Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage?

Visconti¹

2015

Ital J Med

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Proton pump inhibitors (PPIs) are the most potent drugs for reducing gastric acid secretion; so, since their release in the late 1980s, they have been recommended as the first therapeutic choice for many gastroesophageal diseases, risk reduction in or healing of non-steroidal anti-inflammatory drugs-associated ulcer disease and stress ulcer prophylaxis in intensive care unit patients. Thus PPIs account for a significant proportion of pharmaceutical health-care expenditure. Much of this high expenditure results from overuse of PPIs in account of inappropriate indications or prolongation of therapies for excessive time compared to real need. PPIs overutilization occurs in all medical care settings: in the majority of hospitalized patients with low risks for gastrointestinal bleeding, in patients healed at discharge from hospital, in outpatients in ambulatory practice. However potential adverse effects associated with PPIs therapy have been described, including enteric (especially by Clostridium difficile in elderly patients) and pneumonia infections, nutritional deficiencies, rebound acid hypersecretion, acute interstitial nephritis, gastric neoplasms, bone fractures. Caution is required for some coprescription, particularly with clopidogrel.

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Atrophic gastritis during long‐term omeprazole therapy affects serum vitamin B₁₂ levels

Abstract: The development of atrophic gastritis during omeprazole treatment in H. pylori-positive GERD patients is associated with a decrease of serum vitamin B12 levels.

Cited by 49 publications

References 7 publications

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

Genotypic, Clinical, and Demographic Characteristics of Children Infected with Helicobacter pylori

Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage?

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Atrophic gastritis during long‐term omeprazole therapy affects serum vitamin B12 levels

Abstract: The development of atrophic gastritis during omeprazole treatment in H. pylori-positive GERD patients is associated with a decrease of serum vitamin B12 levels.

Cited by 49 publications

References 7 publications

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders

Genotypic, Clinical, and Demographic Characteristics of Children Infected with Helicobacter pylori

Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage?

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About

Atrophic gastritis during long‐term omeprazole therapy affects serum vitamin B₁₂ levels