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Gastric bypass surgery refers to a technique in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch, where the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass procedures (GBP ...
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.
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.
Macrocytic anemia can also be caused by the removal of the functional portion of the stomach, such as during gastric bypass surgery, leading to reduced vitamin B 12 /folate absorption. Therefore, one must always be aware of anemia following this procedure. Hypothyroidism; Alcoholism commonly causes a macrocytosis, although not specifically anemia.
After performing gastric bypass surgery, the two hormones related to obesity, leptin and insulin, fall in levels and while lose weight. [13] Roux-en-Y (RYGB) offers two surgical approaches for processing: an open technique or the laparoscopic technique. The majority of cases are still performed with laparoscopy. [13]
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.
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 ...
Low serum levels of Vitamin B12, Vitamin A, Vitamin D, Vitamin E, and Vitamin K are common nutritional deficiencies after the surgery. 1000 mg of Vitamin B12 is recommended monthly, and supplements of vitamins and minerals are also recommended for the first half to full year after the surgery until the rapid weight loss period has passed. [2]
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