Pernicious Anaemia And Stomach Cancer

"Concerns about pernicious anaemia and stomach cancer"

I'm a 54 year old female living in the UK.

I am very worried about the possibility of stomach cancer.

My concerns started a few months ago when I became extremely tired and fatigued. 

Being that I have diabetes type 2, pernicious anemia and have not long been diagnosed with an under active thyroid, it has been difficult for both myself and my doctor to put this down to any one thing.

However, I then suffered an acute attack of indigestion, with the pain mainly in my upper back, between my shoulder blades, it was a horrible gnawing pain. I was also actively belching and burping! I spoke to my doctor who put me on Omeprazole, which did relieve my symptoms to a certain extent, though I was still aware of a kind of "sore" feeling in my upper back still.

I grew tired, more fatigued and found it difficult to carry out even the everyday simple tasks that we all have to do. One task would leave me completely exhausted.

In the end I spoke with my doctor in desperation and near to tears. A full blood count test was carried out, and I was found to be Iron Anemic. I was immediately put on Iron tablets and a referral was made for an appointment with a consultant in the gastroenterology department. This appointment was to be in January.

However today I received a phone call from the hospital to say that the consultant has put me on fast track and that I'm to have a gastroscopy on Christmas Eve, of all days!

I'm literally petrified of both the procedure and what may or may not be found.

My doctor has already explained to me that my symptoms could be that of an ulcer and a few other things that are easy to fix, but I have had this awful feeling of impending doom hanging over me for a few weeks now, just a feeling that something is just not right?

I will add that I am overweight and a smoker.

I will update this as soon as I have a firm diagnosis of whatever it is that I've got. Mandy, UK

Your Pernicious Anaemia And Stomach Cancer Risk

Whilst there is an increased risk of stomach cancer with pernicious anemia or PA, your doctor is quite right in stating that there are benign reasons for your symptoms too. 

It could also explain your iron deficiency anemia and I will explain why. PA is an autoimmune disorder and results in a reduction of stomach acid referred to as achlorhydria. Acid is required for lots of reasons, but one important one is to ionize your dietary iron in to a form that can be absorbed by your intestine. If you have low acid levels, your iron absorption is reduced.

Another thought is a connection between pernicious anemia and other autoimmune diseases. The most obvious, that could be causing your symptoms, is coeliac disease. This condition affects the small bowel and is due to gluten, a protein in wheat, rye and barley, which causes damage to the small intestine wall. This can cause abdominal cramps, anemia, diarrhea (in some), weight loss , tiredness and much more.

Your doctor is right to refer you for investigation and obviously the endoscopy is important in that respect. Hopefully the gastroscopy will give the answer for you and I wish you well with this. 

Reply From Mandy!

Many thanks for your detailed and helpful reply.

I've only just learned of the connection with Pernicious Anaemia and stomach cancer plus various other conditions, I'm glad that you informed me of the connection with PA and Iron Anaemia, that is most interesting.

Having read your reply, I am now able to open my mind up to other far less serious conditions, which, at this time, is very beneficial to me.

I believe the thing to do, if you're at my stage of early investigation, is to keep an open mind, don't immediately jump to conclusions and don't assume anything. Let the doctors do what they feel is necessary and then await what they say.

Whilst the internet is very useful and informative, it's all too easy now for us to become our "own" doctor and to self diagnose. The one thing that I've learned is that good old "Dr Google" will give you all the bad news and will leave out a whole host of other far less serious conditions. It is with the utmost importance that we remember that seeing a "real" doctor is the way to go with any symptoms, they will have all the relevant information and knowledge and will know what investigations are needed, if any. 

I'd also like to say, thank you so much for this fantastic web site, it's the most helpful one that I've ever read, it's both educational, supportive and comforting to me and to many others I would think. I will most definitely recommend your web site to my local hospital and my GP surgery.      

All Clear!

"I had my gastroscopy today. I managed it with no sedation at all, just the spray to numb my throat and I can honestly now say that it was nothing like the nightmare that I thought it would be.

It was a little uncomfortable at times, but I found it easy to tolerate throughout.

The doctors and nurses looking after me, at the Hospital endoscopy unit, were nothing short of brilliant, so kind, understanding and encouraging, I was able to put my complete trust in them.

The most fantastic news is that all was clear, no ulcers or anything else suspicious were seen.

I had four biopsy's taken from different areas. The doctor explained that the iron deficiency anemia could be just where a part of my digestive tract is not absorbing it properly.

I wont have the results of the biopsy's until 20th January when I see the consultant.

I still have my symptoms the same as I have had, but it's looking like we need to look for other conditions that are the culprit."

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