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Re:B12 and amount of intestine used

11 years 6 months ago #25252 by alsimons
Thanks Pat , KC and Mike

I feel like I’m studying for a final exam so much to learn and so little time. Never even imaged that was something to think about. But then again every part has a function so it makes sense. I just asked my wife how much of the large they took out I thought it was 8cm but she said it was more like 12 due to its deterioration. Ouch…………..just kicked myself for not having done this earlier….like 2005

Thanks again and let me what else I might have to bring up on Friday. I will try and get back on later.

Al

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11 years 6 months ago #25242 by kcnorthstar
My surgeon said that not enouogh of my ileum was used to cause B12 problems, but I have it checked yearly ( a simple blood test) So far, My B12 levels have remained normal after 3 years with a neobladder. I think its a good thing
to have tested if your diversion was made from Ileum.

KC

Age 59
DX Jan 2006 - T1B G3
RC - Neobladder June 2006

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11 years 6 months ago #25241 by Patricia
Vitamin B-12 is an essential nutrient that cannot be synthesized by humans. The human liver is the major site of vitamin B-12 storage, and most stores can last approximately 3 years without replacement. The terminal ileum is the exclusive site of vitamin B-12 absorption in humans. Most urinary diversions in which ileum is used are performed in a way to compensate for the physiology of vitamin B-12 absorption; however, more than 50 cm of resection appears to be the critical length at which abnormal B-12 absorption may be expected.

With the addition of intrinsic factor, Pannek et al demonstrated that 20 of 25 (80%) patients with more than 50 cm of ileum who underwent resection for continent diversion demonstrated abnormal Schilling test results.3 Patients with shorter limbs of ileum are not immune to vitamin B-12 deficiency and/or megaloblastic anemia; symptoms may take longer to manifest. Long-term follow-up studies in patients with shorter ileal segments demonstrate a 25-28% incidence of complications from vitamin B-12 deficiency. Patients in whom more than 50 cm ileum is resected are at increased risk for vitamin B-12 deficiency, which usually does not become clinically apparent for at least 2 years.

Pat

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