Patients who undergo such procedures as gastric bypass for weight control are often left with chronic intestinal malabsorption and may have increased risk for anemia, osteoporosis, and a host of other deficiency-related illnesses. Is there a recommended schedule of supplementation and screening for the prevention and management of these post-bypass problems?
—Sarah R. Edmonson, MD, Houston
While it is generally well-accepted that gastric bypass surgery can lead to deficiency states of certain core nutrients, such as vitamin B12, folate, iron, and calcium, it has also been previously shown that there is wide variation in the use of vitamin and mineral supplements by bariatric surgeons following Roux-en-Y gastric bypass and biliopancreatic diversion surgery (Obes Surg. 1999;9:150-154). There are a number of excellent reviews on this topic, but for a well-written summary of recommendations, see “Vitamin and mineral supplementation after gastric bypass surgery” by BM Rhode and LD MacClean (In: Deitel M, Cowan GSM Jr, eds. Update: Surgery for the Morbidly Obese Patient. Toronto, Ontario: FD Communications, Inc.; 2000: chap 19).
—Daniel G. Tobin, MD (105-20)