Vitamin B12 Deficiency in Barrett’s Esophagus and Heart Burn.

Take B-complex for Barrett’s Esophagus
Barrett’s esophagus is a precancerous condition in which the epithelium of lower esophagus deviates from its normal histology. It becomes more like intestinal type. Stomach acid is responsible for this change. The lower oesophagal valve (also called lower oesophagal sphincter LES) prevent the reflex of stomach acids into the oesophagus. But too much distension of stomach, large meals or lying down immediately after taking meals can trigger acid reflux. Some foods cause more secretion of acids so they increase the risk of acidic damage. There are drugs that are used to treat gastro-esophageal reflux and heart burn. These drugs include proton pump inhibitors (such as omeprazole, (Losec), Pantoprazole, Esomeprazole etc) and H2 receptor blockers (Cimetidine, Ranitidine (Zantac) etc). Both of these classes of drugs significantly decrease the amount of acid productions. Proton pump inhibitors decrease the amount of acid production by 90 % . Because of this ability proton pump inhibitors are frequently used to treat heart burn.
But long-term use of these drugs may cause a deficiency of Vitamin B complex, especially Vitamin B12. Because vitamin B 12 needs intrinsic factor for its absorption and intrinsic factor is secreted along with the stomach acids. When the secretion of the stomach is stopped by proton pump inhibitor or other drugs the secretion of an intrinsic factor also decreases and in the absence of intrinsic factor-vitamin B12 can’t be absorbed.
The deficiency of vitamin B12 doesn’t occur in every individual because there are large stores of vitamin B 12 in the liver which prevent its deficiency. But its deficiency can occur rapidly in malnourished individuals and chronic users of acid lowering drugs. Moreover, in the absence of acids the sources of vitamin B12 can’t be broken down and hence vitamin B12 can’t be released.
Vitamin B12 is an essential vitamin and it helps in neurological growth and DNA synthesis. Its deficiency may cause Alzheimer’s disease, polyneuropathies, muscle weakness and dystrophy, and anaemia. Long-term deficiency of vitamin B12 may cause irreversible neurological and brain damage.
So those individuals who take acid-lowering medications should use vitamin B12 supplements. Vitamin B12 can be given by parenteral route (via injection) and liver can store a large amount of vitamin B12. A fully saturated liver can supply vitamin B12 for the period of three years without causing its deficiency even in the absence of fresh supply of B12. Hence nature has taken necessary steps already to prevent the deficiency of this important vitamin.