Can chronic gastritis cause malabsorption?

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Last updated: May 19, 2025View editorial policy

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From the Research

Inactive gastritis can potentially cause malabsorption, particularly of vitamin B12, due to its impact on gastric acid production and enzyme activity, as evidenced by a study published in 2021 1.

Malabsorption Mechanism

Gastritis, even when inactive or chronic, can disrupt normal stomach function, affecting gastric acid production and enzyme activity, which are essential for proper nutrient breakdown. This disruption may lead to inadequate digestion of proteins, vitamins (particularly B12), iron, and calcium, resulting in their reduced absorption in the intestines.

Key Findings

  • A study published in 2021 found that atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods 1.
  • Another study from 2021 reported that long-term usage of acid suppression drugs like PPIs or H2 receptor blockers in the elderly population can result in vitamin B12 deficiency 2.

Treatment and Recommendations

Treatment depends on the underlying cause of gastritis and may include:

  • Proton pump inhibitors (like omeprazole 20-40mg daily)
  • H2 blockers (such as famotidine 20mg twice daily)
  • Antibiotics if H. pylori infection is present Addressing the gastritis often resolves any associated malabsorption issues. In cases where specific nutrient deficiencies have developed, supplementation may be necessary while the gastritis heals.

Important Considerations

  • Regular consumption of fortified foods can be associated with higher vitamin B-12 biomarkers, but may not be sufficient to restore normal vitamin B-12 status in those with atrophic gastritis 1.
  • The use of PPIs or H2 blockers for more than 6 months can lead to vitamin B12 deficiency, highlighting the need for monitoring and potential supplementation 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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