Vitamin B12 Absorption Following Vagectomy and Gastric Surgery

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Abstract
A modification of the Schilling test was used to determine the absorption of orally administered radioactive Co- labeled vitamin Bl2 in dogs following a variety of sugical procedures related to the stomach. In control dogs, an average of 35% of the radioactive vitamin B12 was recovered in the urine during a less than 1% of the radioactive vitamin B12 was recovered in the urine. The interposition of a colon reservior did not alter these results. Following subtotal gastrectomy, only 2% of the vitamin B12 was excreted in the urine. Similar results were noted for animals with gastroduodenostomy and gastrojejunostomy. Vagectomy and pyloroplasty affected a sustained reduction in vitamin B12 absorption. The urinary excretion was 7%. This was not augmented by the oral administration of H C1 but was increased when intrinsic factor was mixed with the radioactive vitamin B12 prior to oral administration. These studies indicate the advisibility of an extended hematologic evaluation of patients subjected to total gastrectomy, subtotal gastrectomy and even vagectomy in consideration of the possible development of macroscytic anemia.