Abstract
The objective of this review is to provide an update on the effectiveness of oral and nasal vitamin B12 (cobalamin) treatment in gastrointestinal (GI) disorders. Relevant articles were identified by PubMed and Google Scholar systematic search, from January 2010 and June 2018, and through hand search of relevant reference articles. Additional studies were obtained from references of identified studies, the Cochrane Library and the ISI Web of Knowledge. Data gleaned from reference textbooks and international meetings were also used, as was information gleaned from commercial sites on the web and data from CARE B12 research group. For oral vitamin B12 treatment, 4 randomized controlled trials (vs. intramuscular), 4 narrative and 4 systematic reviews, and 13 prospective studies fulfilled our inclusion criteria. These studies concerned patients with vitamin B12 deficiency related to: food-cobalamin malabsorption (n = 6), Biermer’s disease (n = 3), veganism or vegetarianism (n = 1), total gastrectomy after Roux-en-Y gastric bypass (n = 2) and Crohn’s disease (n = 1). Four prospective studies include patients with vitamin B12 deficiency related to the aforementioned etiologies, except veganism or vegetarianism. The systematic present review documents that oral vitamin B12 replacement, at a daily dose of 1000 μg (1 mg), was adequate to normalize serum vitamin B12 levels and cure main clinical manifestations related to vitamin B12 deficiency, in GI disorders, and thus, with safety profile. For nasal vitamin B12 treatment, only one preliminary study was available. We conclude that oral vitamin B12 is an effective alternative to intramuscular vitamin B12 (except in patients presenting with severe neurological manifestations). Oral vitamin B12 treatment avoids the discomfort, contraindication (in patients with anticoagulation), and cost of monthly injections.
Highlights
Gastrointestinal (GI) disorders affect millions of people of all ages [1]. They are the most commonly presented GI illnesses seen by doctors in primary care, in internal medicine or in gastroenterology
We searched for articles published between January 2010 and June 2018, using the following key words or associations: “gastrointestinal disorders”, “vitamin B12 deficiency”, “cobalamin deficiency”, “Biermer’s disease”, “pernicious anemia”, “gastrectomy”, “food-cobalamin malabsorption”, “Helicobacter pylori”, “atrophic gastritis”, “inflammatory bowel disease”, “exocrine pancreatic insufficiency”, “oral vitamin B12 therapy”, “oral cobalamin therapy”, “oral vitamin B12 treatment”, “oral cobalamin treatment”, “nasal vitamin B12 therapy”, and “nasal cobalamin therapy”; restrictions included: English- or French-language publications; published from 1 January 2010, to 1 July 2018; human subjects; adults and elderly subjects, clinical trials, review articles or guidelines
- Improvement of clinical abnormalities in 20% of the patients
Summary
Gastrointestinal (GI) disorders affect millions of people of all ages [1]. They are the most commonly presented GI illnesses seen by doctors in primary care, in internal medicine or in gastroenterology. The social and economic costs of GI disorders are enormous The symptoms of these disorders can cause discomfort ranging from inconvenience to deep suffering or severe and even life-threatening manifestations [2]. Several of these GI disorders can lead to or be associated with a vitamin B12 (cobalamin) deficiency [3]. The treatment of B12 deficiency is based on the parenteral administration of this vitamin [1,5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
