Incidence of Megaloblastic Anemia after Total Gastrectomy

THE investigations of Castle and co-workers1 2 3 4 5 6 over the past quarter century strongly support the thesis that pernicious anemia is the result of a gastric defect manifested by an inadequate production of intrinsic factor, which is responsible for absorption of extrinsic factor, or vitamin B12, from the gastrointestinal tract. If pernicious anemia is not a more complex deficit than a lack of intrinsic factor and if the stomach is the only source of this material, one would expect pernicious anemia to develop invariably after total gastrectomy. Studies utilizing the fecal or urinary excretion of radioactive vitamin B12 as . . .