Which vitamin deficiency may occur in chronic gastritis?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Medical Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Chronic gastritis, particularly the atrophic type, leads to inflammation and destruction of the stomach's parietal cells.
Parietal cells are responsible for secreting intrinsic factor (IF), a glycoprotein essential for Vitamin B12 absorption.
Without intrinsic factor, dietary Vitamin B12 cannot be absorbed in the terminal ileum, leading to a deficiency.
This specific type of deficiency results in pernicious anemia, a form of megaloblastic anemia with potential neurological complications.

Option A: Vitamin A is a fat-soluble vitamin. Its absorption is dependent on dietary fats and bile salts in the small intestine, not on intrinsic factor produced by the stomach.
Option C: Vitamin C is a water-soluble vitamin absorbed in the small intestine through active transport. Its absorption mechanism is independent of gastric intrinsic factor.
Option D: Vitamin E is a fat-soluble vitamin, and like Vitamin A, its absorption relies on dietary fats and bile, not on intrinsic factor from the stomach.

Clinical Relevance

Nursing practice connection: Knowing Vitamin deficiency associated with chronic gastritis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must monitor patients with chronic gastritis for signs and symptoms of Vitamin B12 deficiency, such as fatigue, pallor, paresthesias (numbness/tingling in extremities), and cognitive changes (e.g., confusion, memory loss).
Patient education is a key nursing responsibility. Patients with pernicious anemia must understand the need for lifelong Vitamin B12 replacement, which is typically administered via intramuscular injections because oral supplements cannot be absorbed.
What if? If a patient undergoes a total gastrectomy (surgical removal of the stomach), they will also develop a Vitamin B12 deficiency for the same reason: the source of intrinsic factor is removed. These patients also require lifelong parenteral Vitamin B12 therapy.

How to Approach the Question

First, identify the key terms in the question: 'chronic gastritis' and 'vitamin deficiency'.
Recall the primary functions of the stomach, especially its role in digestion and absorption.
Remember that the stomach produces a unique substance called intrinsic factor, which is vital for the absorption of a specific vitamin.
Connect the pathology of 'chronic gastritis' (inflammation and atrophy of the stomach lining) to the cells that produce intrinsic factor (parietal cells).
Evaluate the options to determine which vitamin's absorption is exclusively dependent on intrinsic factor.
Conclude that Vitamin B12 is the correct answer because its absorption pathway is directly disrupted by the damage caused by chronic gastritis.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 138-140