Bariatric surgeries are increasingly used to treat overweight and obese patients who have clinically relevant signs and symptoms. Surgeons performed ~196,000 bariatric surgeries in the U.S. in 2015. These procedures can be successful in reversing many adverse syndromes (including diabetes, hypertension, joint pain, obstructive sleep apnea), but there are risks and complications to consider, such as the exacerbation of preexisting nutritional deficiencies and the development of new ones. Some of these deficiencies present early following surgery, but the late presentation of nutritional deficiencies is increasingly recognized to contribute to poor outcomes or devastating complications. Bariatric surgeries using a restrictive technique present a lower risk of subsequent nutritional deficiencies, while restrictive surgeries combined with malabsorptive techniques, such as Roux-en-Y and biliopancreatic diversion (BPD), may pose a higher risk. Therefore, long-term monitoring for nutritional deficiencies is indicated following gastric bypass surgeries.
Panel test:
Ferritin
Folate (RBC, Serum)
Parathyroid hormone
Renal function
Vitamin B12
Vitamin D, 25-hydroxy
References
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2. Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017; 13(5): 727-741. PubMed
3. Weng T, Chang C, Dong Y, Chang Y, Chuang L. Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015; 5(7): e006964. PubMed
4. Lupoli R, Lembo E, Saldalamacchia G, Avola CK, Angrisani L, Capaldo B. Bariatric surgery and long-term nutritional issues. World J Diabetes. 2017; 8(11): 464-474. PubMed
