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Atrophic gastritis during long‐term omeprazole therapy affects serum vitamin B 12 levels
Author(s) -
B.E. Schenk,
Ernst J. Kuipers,
Elly C. KlinkenbergKnol,
Elisabeth Bloemena,
Maria I. Sandell,
G. F. Nelis,
P. Snel,
H. P. M. Festen,
S. G. M. Meuwissen
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00616.x
Subject(s) - cobalamin , atrophic gastritis , omeprazole , gastroenterology , medicine , gastritis , gerd , atrophy , vitamin b12 , reflux , helicobacter pylori , disease
Background : Omeprazole maintenance therapy for gastro‐oesophageal reflux disease (GERD) has been associated with an increased incidence of atrophic gastritis in H. pylori‐ infected patients and with a decreased absorption of protein‐bound, but not of unbound cobalamin. Aim : To test the hypothesis that the combination of decreased cobalamin absorption and atrophic gastritis decreases serum cobalamin levels during omeprazole therapy. Methods : Forty‐nine H. pylori‐ positive GERD patients were treated with omeprazole for a mean (± s.d.) period of 61 (25) months. At the start of omeprazole treatment (T 0 ) and at the latest follow‐up visit (T 1 ), serum was obtained for measurement of cobalamin. Corpus biopsy specimens were obtained at entry and follow‐up for histopathological scoring according to the updated Sydney classification. Results : At inclusion, none of the 49 patients had signs of atrophic gastritis. During follow‐up, 15 patients (33%) developed atrophic gastritis, nine of whom had moderate to severe atrophy. These 15 patients did not differ from the other 34 patients with respect to age, serum cobalamin at T 0 or the duration of follow‐up. During follow‐up, no change was observed in the median serum cobalamin level in the 34 patients without atrophy; (T 0 ) 312 (136–716) vs. (T 1 ) 341 (136–839) pmol/L ( P =0.1). In the 15 patients who developed atrophy, a decrease in cobalamin was seen from 340 (171 to 787) at baseline to 285 (156–716) at latest follow‐up ( P < 0.01). Conclusions : The development of atrophic gastritis during omeprazole treatment in H. pylori‐ positive GERD patients is associated with a decrease of serum vitamin B 12 levels.