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doi: 10.1038/s41598-017-01732-1 80 ConnellyPJPrenticeNPCouslandGBonhamJ

Atrophic gastritis and reduced gastric acid production impair B12 release from food proteins

Because the granulomas in oral Crohn's are often deep and patchy, the biopsy may need to be taken unusually deep, and a single negative biopsy does not rule the condition out