Necessary Supplements Following Bariatric and Metabolic Surgery
Obese patients present with preoperative nutrient deficiencies, decreased postoperative caloric intake, lower contact of food with intestinal enzymes and an altered absorption due to intestinal bypass, associated with avoidance of nutrient rich foods and non compliance with prescribed supplementation that can lead to nutritional deficits causing significant morbidity. This health issues range from anemia, neuropathy, cognitive dysfunction, visual loss or bone loss to anemia and weight regain.
Silvia Leite from the Department of Nutrition at the University of Brasilia explains the differences between the patients compliant with the prescribed multivitamin supplementation and non-compliant patients. A thorough review of physiological intestinal absorption of nutrients and the expected deficiencies for each type of bariatric procedure (laparoscopic adjustable gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, single anastomosis gastric bypass and duodenal switch) is provided. Recommendations on prevention, screening and treatment of nutritional deficiencies after bariatric procedures are explained for each possible deficiency.
An interesting debate between IFSO experts S. Leite, T. Martinez, S.S. Dagan, M. O’Kane and J. Parrott on important issues in prevention and treatment of nutritional deficiencies after bariatric surgery follows.