Studies on Intestinal Absorption of Vitamin B12 in Totally Gastrectomized Patients

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It has been well known that vitamin B12 is absorbed from the intestinal tract in the presence of intrinsic factor. Suggestions have been made that liver B12 is absorbed without intrinsic factor, and that lack of B12 merely represents maldigestion in the stomach. This communication deals with our study to clarify the role of intrinsic factor in vitamin B12 absorption in subjects without stomach, and digestibility and absorbability of liver bound B12. Liver containing 57Co-B12 was prepared by repeated injection of the vitamin to rats, and was fed to test subjects. In addition, a patient with an intestinal fistulae was used for study.The following results were obtained;1) Vitamin B12 malabsorption in patients with total gastrectomy was due mainly to absence of intrinsic factor.2) No evidence was obtained that absorption of liver bound B12 was superior to that of aqueous B12. Hence, liver proteins have no intrinsic factor-like activity.3) Following oral administration of hog intrinsic factor, the activity continued to be demonstrable in the small intestine for at least two hours.4) A patient who had had total gastrectomy and showed normal absorption of vitamin B12 has been described.
財団法人日本消化器病学会の論文