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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.
Specific vitamin deficiencies also occur; Vitamin D and Calcium deficiencies lead to thinning of bone with bone pain and fractures as a result of osteoporosis and osteomalacia. Bypass of the terminal ileum, which is the specific site of vitamin B 12 absorption, leads to Vitamin B 12 deficiency with a specific peripheral neuropathy .
Sleeve gastrectomy, also known as a gastric sleeve, is a surgical weight-loss procedure where the stomach size is reduced by the surgical removal of a large portion of the stomach, following along the major curve of the stomach. [2]
Sleeve gastrectomy or vertical sleeve gastrectomy, is a surgical weight-loss procedure, typically performed laparoscopically, in which approximately 75 - 85% of the stomach is removed, [1] [2] along the greater curvature, [3] which leaves a cylindrical, or "sleeve"-shaped stomach the size of a banana.
The Recommended Dietary Allowance (RDA) for vitamin B12 is 0.9-2.4 μg/day, while the estimated average requirement in the U.S. and Canada is 0.7-2 μg/day. Elderly individuals with plasma vitamin B12 levels below 148 pmol/L are considered severely deficient, and those with levels between 148 and 221 pmol/L are marginally deficient.
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.
The SADI-S is a single anastomosis bariatric surgery. It is different from the classic duodenal switch, the gastric bypass (RNY) or sleeve gastrectomy.It is a type of bariatric surgery carried out to lose weight and to mitigate various metabolic issues including type 2 diabetes, dislipidemia, metabolic syndrome, and polycystic ovary syndrome.
The alkaline environment causes the retained gastric tissue to produce acid, which may result in ulcers in a rare complication known as retained antrum syndrome. All patients lose weight after gastrectomy, although the extent of weight loss is dependent on the extent of surgery (total gastrectomy vs partial gastrectomy) and the pre-operative BMI.
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