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Vitamin B 12 deficiency is quite common after gastric bypass surgery with reported rates of 30% in some clinical trials. [journal 13] Sublingual B 12 (cyanocobalamin) appears to be adequately absorbed. In cases where sublingual B 12 does not provide sufficient amounts, injections may be needed. Protein malnutrition is a real risk.
Impaired B 12 absorption can also occur following gastric removal (gastrectomy) or gastric bypass surgery. In these surgeries, either the parts of the stomach that produce gastric secretions are removed or they are bypassed. This means intrinsic factor, as well as other factors required for B 12 absorption, are not available.
Various methods of gastric bypass or gastric restriction surgery are used to treat morbid obesity. Roux-en-Y gastric bypass surgery (RYGB) but not sleeve gastric bypass surgery or gastric banding, increases the risk of vitamin B 12 deficiency and requires preventive post-operative treatment with either injected or high-dose oral supplementation.
Cyanocobalamin is a form of vitamin B 12 used to treat and prevent vitamin B 12 deficiency except in the presence of cyanide toxicity. [7] [8] [2] The deficiency may occur in pernicious anemia, following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer.
Intestinal bypass surgery can lead to loss of weight effectively, but it can also lead to various complications that should not be neglected. About half of the patients who received this surgery need rehospitalization to manage the complications. [5] The expected outcomes and possible risks of the intestinal bypass surgery are shown as follows:
Hydroxocobalamin, also known as vitamin B 12a and hydroxycobalamin, is a vitamin found in food and used as a dietary supplement. [1] As a supplement it is used to treat vitamin B12 deficiency including pernicious anemia.
A person may need surgery if dumping syndrome is caused by previous gastric surgery or if the condition is not responsive to other treatments. For most people, the type of surgery depends on the type of gastric surgery performed previously. However, surgery to correct dumping syndrome often has unsuccessful results. [1]
The Schilling test has multiple stages. [3] As noted below, it can be done at any time after vitamin B 12 supplementation and body store replacement, and some clinicians recommend that in severe deficiency cases, at least several weeks of vitamin repletion be done before the test (more than one B 12 shot, and also oral folic acid), in order to ensure that impaired absorption of B 12 (with or ...