Enteral vitamin B12 supplements reverse postgastrectomy B12 deficiency

Area of Science:

• Gastroenterology
• Hematology
• Nutritional Science

Background:

• Postgastrectomy anemia is linked to iron and vitamin B12 deficiencies.
• Current treatment for post-surgical vitamin B12 deficiency primarily involves parenteral administration.
• Guidelines for prophylactic vitamin B12 use and the clinical presentation of deficiency post-gastrectomy are lacking.

Purpose of the Study:

• To investigate the development of vitamin B12 deficiency after total gastrectomy.
• To assess the clinical and chemical manifestations of vitamin B12 deficiency in this patient group.
• To evaluate the effectiveness of oral vitamin B12 supplementation.

Main Methods:

• Serum vitamin B12 levels were monitored in 31 patients post-total gastrectomy.
• Patients were surveyed for symptoms associated with vitamin B12 deficiency.
• Vitamin B12 levels were measured every six months in 10 patients.
• Treatment efficacy was compared between 18 patients receiving oral B12 and 13 receiving intramuscular injections.

Main Results:

• Vitamin B12 levels fell below normal within 1-4 years in a significant portion of patients.
• Seventy-eight percent of patients reported symptoms indicative of vitamin B12 deficiency.
• Oral vitamin B12 administration led to a rapid increase in serum B12 levels and complete symptom resolution.

Conclusions:

• Vitamin B12 deficiency can manifest as early as one year following total gastrectomy.
• Oral vitamin B12 (cobalamin) therapy is effective in increasing serum B12 levels and resolving deficiency symptoms.
• Routine prescription of oral vitamin B12 is recommended for patients undergoing total gastrectomy.