Absorption of Vitamin B12 in Patients with Anaemia after Polya Partial Gastrectomy

SUMMARY The absorption of radioactive vitamin B12 (cyanocobalamin) has been studied by the Schilling procedure in 27 patients with anaemia after Polya partial gastrectomy and in 10 patients with Addisonian pernicious anaemia. In patients who have had Polya partial gastrectomy absorption of vitamin B12 was often increased when the dose was given with a meal containing only a small quantity of the vitamin, and when the dose was given after an injection of histamine. In the patients with pernicious anaemia histamine did not enhance absorption of vitamin B12, and food did not alter the absorption of the vitamin when given with a small quantity of intrinsic factor. Improved absorption of vitamin B12 with food or after histamine is likely to be due to stimulation of a small residual secretion of intrinsic factor. The results of the standard fasting Schilling test appeared to correlate better with the development of deficiency of vitamin B12 than tests with food or after histamine.