Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment

Abstract In recent years, the recourse to obesity surgery to treat morbid obesities has grown. The number of “malabsorptive” interventions, such as the gastric bypass (RYGB: Roux-en-Y gastric bypass) increases each year. The RYGB, which combines two mechanisms promoting weight loss, restriction and...

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Bibliographic Details
Published in:Diabetes & metabolism 2007-02, Vol.33 (1), p.13-24
Main Authors: Poitou Bernert, C, Ciangura, C, Coupaye, M, Czernichow, S, Bouillot, J.L, Basdevant, A
Format: Article
Language:English
Subjects:
Bariatric surgery
Biological and medical sciences
Bypass gastrique Roux-en-Y
Chirurgie bariatrique
Diabetes. Impaired glucose tolerance
Diet
Déficits nutritionnels
Endocrine pancreas. Apud cells (diseases)
Endocrinology & Metabolism
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Gastric Bypass - adverse effects
Gastric Bypass - methods
Grossesse
Humans
Internal Medicine
Malabsorption
Malnutrition - diagnosis
Malnutrition - etiology
Malnutrition - prevention & control
Malnutrition - therapy
Medical sciences
Metabolic diseases
Micronutrients
Nutritional deficiency
Obesity - prevention & control
Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...)
Pregnancy
Pregnancy Complications - etiology
Pregnancy Complications - prevention & control
Review
Revue générale
Roux-en-Y gastric bypass
Supplementation
Suppléments
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Vitamines
Vitamins
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Summary:Abstract In recent years, the recourse to obesity surgery to treat morbid obesities has grown. The number of “malabsorptive” interventions, such as the gastric bypass (RYGB: Roux-en-Y gastric bypass) increases each year. The RYGB, which combines two mechanisms promoting weight loss, restriction and malabsorption, has proven its effectiveness in term of weight loss and improvement of obesity-associated co-morbidities. However this intervention involves a profound change in digestive physiology and is the source of nutritional and metabolic complications. The deficits observed most frequently concern proteins, iron, calcium, vitamin B12 and vitamin D. The deficiencies in vitamin B1 are rare but potentially serious. Multidisciplinary follow-up is essential to ensure prevention, diagnosis and treatment of these complications. Based on an analysis of the literature, this article summarizes the various nutritional complications observed after RYGB and the means to diagnose it. It proposes practical recommendations for follow-up, preventive supplementation and treatment of these deficiencies, both generally and in the more specific case of a pregnancy after RYGB.
ISSN:1262-3636
1878-1780
DOI:10.1016/j.diabet.2006.11.004