One Anastomosis Gastric Bypass Surgery: Consequences Over Ascorbic Acid, Cobalamin, Calciferol, and Calcium (original) (raw)
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Nutritional Deficiencies in Bariatric Surgery Candidates
Obesity Surgery - OBES SURG, 2010
Background To assess the prevalence of nutritional deficiencies amongst people who suffer from morbid obesity and are candidates for bariatric surgery and to evaluate the relations between pre-operative nutritional deficiencies and demographic data and co-morbidities. Methods Preoperative blood tests of 114 patients (83 women and 31 men) were collected. The blood tests included plasma chemistry (including albumin, total protein, iron, ferritin, vitamin B12, folic acid, parathyroid hormone (PTH), calcium, and phosphorous) and a blood count (for hemoglobin and mean corpuscular volume (MCV)). Demographic and socio-economic details were collected from all patients. Results Mean age, weight, and BMI of the patients were 38 years (15–77), 122.9 kg (87–250), and 44.3 kg/m2 (35.3–74.9), respectively. The prevalence of pre-operative nutritional deficiencies were: 35% for iron, 24% for folic acid, 24% for ferritin, 3.6% for vitamin B12, 2% for phosphorous, and 0.9% for calcium, Hb and MCV ...
IP innovative publication pvt. ltd, 2019
Introduction: Presently, bariatric surgery is considered the most compelling treatment modality for morbid obesity patient and one of the most effective procedures. The study aimed to identify the prevalence and determinants of patients' compliance to the recommended vitamin and mineral supplements and to identify the prevalence and determinants of post-bariatric surgery nutritional deficiencies in King Fahad General Hospital in Jeddah city so as to improve the patients' health. Materials and Methods: This is a cross-sectional study wherein a validated questionnaire was used to collect data and were encoded and analyzed using IBM SPSS version 23, (IBD Corp., Armonk, NY). Results: The findings of the study showed that nutritional deficiency is more likely to happen to female gender who is working. The study also revealed that deficiencies are common in HB, Vit D, Vit B12, calcium, iron and folate. The longer the period of intensive fluid taken following surgery increases the risk of vitamin deficiency. Furthermore, there's low compliance to vitamins and supplements and patients who underwent bariatric surgery only become adherent to vitamins/minerals when they discover complications. Conclusion: This study concluded that there are various factors causing and affecting nutritional deficiencies preoperatively and postoperatively such as gender, work status, complications, and vitamins and supplements compliance. Overall, the present study concluded that it is imperative for the patients to adhere to vitamins and supplements intake according to the recommendation of the clinicians and dieticians.
Origins of and recognition of micronutrient deficiencies after gastric bypass surgery
Current diabetes reports, 2011
Roux-en-Y gastric bypass surgery remains the major surgical option for individuals with medically complicated obesity. The importance of preoperative evaluation to permit identification of micronutrient deficiencies is being re-evaluated. The risk of complications related to pregnancy after gastric bypass supports careful follow-up. Micronutrient deficiencies are common in postoperative gastric bypass patients, despite the suggested use of routine vitamin and mineral supplements after surgery. Copper deficiency must be considered as an origin for visual disorders after gastric bypass. Vitamin D deficiency with metabolic bone disease remains common after gastric bypass and the results suggest that the present postoperative supplements of calcium and vitamin D are inadequate. Major nutritional complications of bariatric surgery are occurring more than 20 years after surgery. There is no evidence for intestinal adaptation as there remains decreased intestinal absorption of iron up to 1...
Vitamin status after gastric bypass and lifestyle intervention: a comparative prospective study
Surgery for Obesity and Related Diseases, 2012
Background: Bariatric surgery can lead to vitamin deficiencies. We aimed to assess the changes in blood vitamin concentrations in patients who were taking predefined supplements after gastric bypass surgery. Methods: A total of 29 patients underwent gastric bypass and 24 unmatched controls underwent lifestyle intervention in a prospective, nonrandomized trial. The patients in the surgical group received multivitamin, iron, calcium, vitamin D, and vitamin B 12 supplements. No supplements were prescribed to the lifestyle group. The median body mass index decreased from 46 to 32 kg/m 2 after surgery and from 40 to 39 kg/m 2 after lifestyle intervention. Results: Of the 53 included patients, 50 completed the 1-year follow-up examination (94%). Compared with the lifestyle patients, the surgical patients had increased vitamin B 6 , folic acid, vitamin B 12 , and lipid-adjusted vitamin E (P Ͻ.02 for each) concentrations but decreased vitamin A concentrations (P Ͻ.01) during follow-up. No significant difference between the 2 groups was found for vitamin B 1 , vitamin C, or 25-hydroxyvitamin D. Most surgical patients reported taking their supplements. Conclusion: Gastric bypass patients adhering to a set of dietary supplements had mostly stable or increased vitamin concentrations compared with both their baseline values and the changes in a nonsurgical control group. (Surg Obes Relat Dis 2011;xx:xxx.)
Need for Multivitamin Use in the Postoperative Period of Gastric Bypass
Obesity Surgery, 2008
Background Based on the reduced gastric volume and the malabsorption produced by Roux-en-Y gastric bypass (RYGBP) and diet therapy, it is essential in the postoperative period to obtain and maintain an adequate nutritional state, with the aim of preventing malnutrition and seeking a healthy life. It is observed that patients have difficulty in understanding the new food choices that must considered, as they have eating habits that are very divergent from those currently proposed. There is often the need for vitamin and mineral replacement after laboratory tests. Methods This study calculated and evaluated the 24-h eating records of 210 patients, collected in the course of nutritional visits in follow-ups of the first, third, sixth, ninth, 12th, 18th, and 24th months postoperative. Results It was possible to observe an increase in the consumption of nutrients in the course of the study period, but it was not regular and significant for all the nutrients. Also, it is noted that the minimal requirements for vitamin A, vitamin C, calcium, iron and B-complex vitamins (except for cyanocobalamin and riboflavin) were not attained. The nutrients in which satisfactory results were obtained were total proteins of high biological value: cyanocobalamin and riboflavin. Conclusion This study demonstrated the concern for nutrient supplementation in the postoperative period of RYGBP. Thus, the routine use of multivitamins is deemed necessary after the first month postoperatively, with its maintenance preferably for the rest of the patient's life, without abandoning periodic clinical and laboratory follow-up.
Journal of Surgery
In Egypt, sleeve gastrectomy and one anastomosis gastric bypass (OAGB) are popular bariatric procedures. The current study was conducted to compare between these two procedures regarding short-term weight loss, comorbidity improvement, vitamin and micronutrient changes. This prospective study included 40 cases who were divided into two equal groups; sleeve gastrectomy and OAGB groups. All cases received the standard perioperative care. Our primary outcome was serum nutrient changes (hemoglobin, iron, calcium, vitamin D, and vitamin B 12), while secondary outcomes included weight loss parameters along with the improvement of obesity related comorbidities. These data were recorded 3, 6, and 12 months after operation, and then compared to the corresponding baseline values. Demographic criteria were comparable between the two groups, apart from diabetes which was more prevalent in the OAGB group. Both groups were followed by a significant and comparable weight loss at the short-term after operation. Both groups were associated with significant improvement in DM and hypertension at 12 months. Most evaluated vitamin and nutrient levels were comparable between the two groups except for hemoglobin, iron and vitamin B 12 levels, which were significantly higher with sleeve gastrectomy at 6-and 12-month follow up. Both sleeve gastrectomy and OAGB are effective bariatric procedures that could achieve satisfactory weight loss and improvement of comorbidities. However, OAGB carries higher risk of iron, hemoglobin and vitamin B 12 deficiency.
Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch
The American Journal of Clinical Nutrition, 2009
Background: Bariatric surgery is widely performed to induce weight loss. Objective: The objective was to examine changes in vitamin status after 2 bariatric surgical techniques. Design: A randomized controlled trial was conducted in 2 Scandinavian hospitals. The subjects were 60 superobese patients [body mass index (BMI; in kg/m 2): 50-60]. The surgical interventions were either laparoscopic Roux-en-Y gastric bypass or laparoscopic biliopancreatic diversion with duodenal switch. All patients received multivitamins, iron, calcium, and vitamin D supplements. Gastric bypass patients also received a vitamin B-12 substitute. The patients were examined before surgery and 6 wk, 6 mo, and 1 y after surgery. Results: Of 60 surgically treated patients, 59 completed the followup. After surgery, duodenal switch patients had lower mean vitamin A and 25-hydroxyvitamin D concentrations and a steeper decline in thiamine concentrations than did the gastric bypass patients. Other vitamins (riboflavin, vitamin B-6, vitamin C, and vitamin E adjusted for serum lipids) did not change differently in the surgical groups, and concentrations were either stable or increased. Furthermore, duodenal switch patients had lower hemoglobin and total cholesterol concentrations and a lower BMI (mean reduction: 41% compared with 30%) than did gastric bypass patients 1 y after surgery. Additional dietary supplement use was more frequent among duodenal switch patients (55%) than among gastric bypass patients (26%). Conclusions: Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery. Patients who undergo these 2 surgical interventions may require different monitoring and supplementation regimens in the first year after surgery. This trial was registered at clinicaltrials.gov as NCT00327912.
Nutritional deficiencies after bariatric surgery
Obesity Surgery, 2007
Lifestyle intervention programmes often produce insufficient weight loss and poor weight loss maintenance. As a result, an increasing number of patients with obesity and related comorbidities undergo bariatric surgery, which includes approaches such as the adjustable gastric band or the 'divided' Roux-en-Y gastric bypass (RYGB). This Review summarizes the current knowledge on nutrient deficiencies that can develop after bariatric surgery and highlights follow-up and treatment options for bariatric surgery patients who develop a micronutrient deficiency. The major macronutrient deficiency after bariatric surgery is protein malnutrition. Deficiencies in micronutrients, which include trace elements, essential minerals, and watersoluble and fat-soluble vitamins, are common before bariatric surgery and often persist postoperatively, despite universal recommendations on multivitamin and mineral supplements. Other disorders, including small intestinal bacterial overgrowth, can promote micronutrient deficiencies, especially in patients with diabetes mellitus. Recognition of the clinical presentations of micronutrient deficiencies is important, both to enable early intervention and to minimize long-term adverse effects. A major clinical concern is the relationship between vitamin D deficiency and the development of metabolic bone diseases, such as osteoporosis or osteomalacia; metabolic bone diseases may explain the increased risk of hip fracture in patients after RYGB. Further studies are required to determine the optimal levels of nutrient supplementation and whether postoperative laboratory monitoring effectively detects nutrient deficiencies. In the absence of such data, clinicians should inquire about and treat symptoms that suggest nutrient deficiencies.
Nutritional status following One Anastomosis Gastric Bypass
Clinical Nutrition
BACKGROUND & AIMS One Anastomosis Gastric Bypass (OAGB) has been accepted as an effective treatment for morbid obesity. However, data are scarce regarding nutritional implications of this procedure. Thus, our aim was to describe the health and nutritional status 12-20 months following OAGB surgery. METHODS A prospective cohort study on patients who underwent OAGB surgery from January 2016 to May 2017 in a large, multi-disciplinary, bariatric clinic. Pre-surgery data including demographic details, anthropometrics, co-morbidities, blood tests and lifestyle habits were obtained from the patients' medical records. Follow-up evaluations were performed 12-20 months post-surgery and data collected included anthropometrics, blood tests, eating and lifestyle parameters, adherence to follow-up regime and gastrointestinal (GI) related side effects. In addition, patients were asked to rate their overall state of health (OSH) from 0 to 100 using a visual analogue scale (VAS). RESULTS Eighty-six OAGB patients (72.1% women) were tested 14.7 ± 2.0 months post-operatively. Their mean age and BMI preoperatively were 46.1 ± 11.4 years and 42.0 ± 4.9 kg/m2, respectively. The mean % excess weight loss at 12-20 months postoperatively was 88.4 ± 19.3%. Lipid and glucose profiles were significantly improved at 12-20 months postoperatively compared to baseline (P < 0.001 for all). Relatively high proportions of nutritional deficiencies were found pre-operatively and postoperatively for iron (33.9% vs. 23.7%, P = 0.238), folate (30.9% vs. 11.8%, P = 0.004), vitamin D (56.6% vs. 17.0%, P < 0.001) and hemoglobin (16.7% vs. 42.9%, P < 0.001). Postoperatively, most participants reported taking multivitamin, calcium, vitamin D and vitamin B12 supplementation (≥62.8%), having participated in at least 6 meetings with a dietitian (51.8%) and presently doing physical activity (69.4%). The mean postoperative OSH VAS score was 88.2 ± 12.3, but most participants reported on flatulence (67.4%) and some reported on diarrhea (25.6%) as GI side effects of the surgery. CONCLUSIONS Substantial improvements in health and anthropometric parameters are found in the short-term follow-up after OAGB, with a satisfactory reported quality of life and adherence to recommendations. However, a high prevalence of some GI side effects, nutritional deficiencies and specially anemia is a matter of concern.
2021
Long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies are few. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1±10.6 yrs, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients sleeve gastrectomy (LSG) and 11 subjects adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight was 60.6%±32.3. 80.7% of subjects (72.7%, AGB; 76%, SG; 93.7%, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Average weight loss was constant in...