Nutritional Deficiencies and Bariatric Surgery

2018 ◽  
Author(s):  
Anthony B. Mozer ◽  
Konstantinos Spaniolas ◽  
Walter J. Pories
Keyword(s):  
Bariatric Surgery ◽  
Oral Intake ◽  
Emergency Department Visits ◽  
Nutritional Deficiencies ◽  
Vitamin Supplementation ◽  
Behavioral Modification ◽  
Poor Oral Intake ◽  
Preoperative Counseling ◽  
Disproportionate Number

Dietary intolerance and poor oral intake account for a disproportionate number of emergency department visits and readmissions after bariatric surgery. Micronutrient, vitamin, and protein deficiencies can occur after both malabsorptive and restrictive weight-loss operations, and they are best mitigated against by conscientious preoperative counseling and vigilance in follow-up. Routine vitamin supplementation can prevent the need for unnecessary laboratory testing, while symptoms of dumping syndrome can frequently be managed with dietary and behavioral modification alone. Alternative enteral feeding access for alimentary supplementation can be safely performed surgically or with assistance by interventional radiology, and should be considered in the management of perforation, early anastomotic leak, surgical revision, or patients with refractory malnourishment.

scholarly journals A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

2021 ◽  
pp. 1-3
Author(s):  
Gulay Kocak ◽  
Munevver Gul Avsar ◽  
Cansu Yazar ◽  
Aylia Yesilova ◽  
Gulcagri Yildiz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Sleeve Gastrectomy ◽  
Dilated Cardiomyopathy ◽  
Selenium Deficiency ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Reduced Ejection Fraction ◽  
Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

Poor functional recovery after delirium is associated with other geriatric syndromes and additional illnesses

2014 ◽  
Vol 27 (5) ◽  
pp. 793-802 ◽  
Author(s):  
Monidipa Dasgupta ◽  
Chris Brymer
Keyword(s):  
Functional Recovery ◽  
Functional Decline ◽  
Oral Intake ◽  
Geriatric Syndromes ◽  
Physical Restraints ◽  
Security Services ◽  
Increased Risk ◽  
Poor Oral Intake ◽  
Discharge From Hospital

ABSTRACTBackground:Delirious individuals are at increased risk for functional decline, institutionalization and death. Delirium is also associated with other geriatric syndromes, behavioral care issues, and new illnesses. The objectives of this study were to determine how often certain geriatric syndromes, care issues, and additional diagnoses occur in delirious individuals, and to see whether they correlate with worse functional recovery.Methods:Consecutive delirious older medical in-patients (n = 343) were followed for the occurrence of geriatric syndromes (falls, pressure ulcers, poor oral intake, and aspiration), care issues (refusing treatments or care, need for sitters, security services, physical restraints, and new neuroleptic medications) and additional diagnoses occurring after the third day of admission. Poor functional recovery was defined by any one of death, permanent institutionalization or increased dependence for activities of daily living (ADLs) at discharge or three months after discharge from hospital, elicited through chart review or a follow-up telephone interview.Results:Poor functional recovery was seen in 237 (69%) delirious patients. Geriatric syndromes and additional illnesses were common and associated with poor functional recovery (falls in 21%, adjusted OR 2.27; possible aspiration in 26%, adjusted OR 3.06; poor oral intake in 49%, adjusted OR = 2.31; additional illnesses in 38%, adjusted OR 3.54). Care issues were also common (range 9%–54%) but not associated with poor recovery.Conclusions:Geriatric syndromes, behavioral care issues and additional illnesses are common in delirium. Future studies should assess whether monitoring for and intervening against geriatric syndromes and additional illnesses may improve functional outcomes after delirium.

scholarly journals Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study

2020 ◽  
pp. bjgp20X714161
Author(s):  
Helen Parretti ◽  
Anuradhaa Subramanian ◽  
Nicola Adderley ◽  
Abbott Sally ◽  
Tahrani Abd ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Primary Care ◽  
Cohort Study ◽  
Nutritional Supplements ◽  
Nutritional Deficiencies ◽  
Future Research ◽  
Blood Tests ◽  
Weight Measurement ◽  
Post Surgery

Abstract Background: Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks. Aim: To investigate whether nutritional and weight monitoring in primary care meets current clinical guidance, post-specialist discharge. Design and setting: Retrospective cohort study. Primary care practices contributing to IQVIA Medical Research Data (IMRD)–UK (1/1/2000-17/1/2018). Methods: Participants were adults who had had bariatric surgery with a minimum of three years’ follow-up post-surgery as this study focused on patients discharged from specialist care (at 2yrs post-surgery). Outcomes were annual proportion of patients from 2yrs post-surgery with a record of recommended nutritional screening blood tests, weight measurement and prescription of nutritional supplements, and proportions with nutritional deficiencies based on blood tests. Results: 3137 participants were included and median follow-up post-surgery was 5.7 (4.2-7.6) years. 45-59% had an annual weight measurement. The greatest proportions of patients with a record of annual nutritional blood tests were for tests routinely conducted in primary care, e.g. recorded haemoglobin measurement varied between 44.9% (n=629/1400) and 61.2% (n=653/1067). Annual proportions of blood tests specific to bariatric surgery were low, e.g. recorded copper measurement varied between 1.2% (n=10/818) and 1.5% (n=16/1067) (where recommended). Results indicated that the most common deficiency was anemia. Annual proportions of patients with prescriptions for recommended nutritional supplements were low. Conclusions: Our study suggests that bariatric surgery patients are not receiving recommended nutritional monitoring post-specialist discharge. GPs and patients should be supported to engage with follow-up care. Future research should aim to understand reasons underpinning our findings.

scholarly journals Adherence to Vitamin Supplementation Recommendations in Youth Who Have Undergone Bariatric Surgery as Teenagers: a Mixed Methods Study

2020 ◽  
Vol 30 (12) ◽  
pp. 4911-4918
Author(s):  
Anna Lena Brorsson ◽  
Karin Nordin ◽  
Kerstin Ekbom
Keyword(s):  
Bariatric Surgery ◽  
Vitamin D ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Nutritional Deficiencies ◽  
Vitamin Supplementation ◽  
Structured Interviews ◽  
Vitamin D Levels ◽  
A Prospective Study ◽  
Qualitative Part

Abstract Purpose Adherence to vitamin supplementation recommendations after bariatric surgery is generally poor, which is associated with nutritional deficiencies. Patients’ own perspectives and reasons for poor adherence to vitamin supplementation recommendations have not yet been studied in depth. The purpose of this study was first to measure the accuracy of self-reported adherence to supplementation recommendations by using objective measures of vitamin D levels in blood and thereafter to explore perceptions of barriers and facilitators to participants’ adherence to supplementation recommendations. Material and Method Participants were recruited from a prospective study investigating the outcome of bariatric surgery in adolescents with severe obesity. Mixed methods were used, including a quantitative part where vitamin D levels were analysed through 25(OH)D levels in blood and/or a questionnaire on adherence to supplementation programmes 5 years after surgery (n = 40) plus a qualitative part with semi-structured interviews (n = 20). Results We found a convergence between self-reported adherence to vitamin supplementation and vitamin D 25(OH)D levels in blood indicating honestly in self-reported responses. The qualitative evaluations resulted in the categories awareness and personal capability and external factors. In the analysis, an overall theme emerged; capacity is crucial for adherence in youth who have undergone bariatric surgery. Conclusion Bariatric surgery is a comprehensive procedure that requires lifelong treatment afterwards. There is coherence between what adolescents actually do and what they say they do. Capacity is crucial for adherence and social support has been shown to be important.

scholarly journals Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery

2006 ◽  
Vol 64 (3a) ◽  
pp. 609-612 ◽  
Author(s):  
Flavia Costa Nunes Machado ◽  
Berenice Cataldo Oliveira Valério ◽  
Roberto Naun Franco Morgulis ◽  
Karlo Faria Nunes ◽  
Sílvia Mazzali-Verst
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Neurological Complication ◽  
Neurological Complications ◽  
Gastric Surgery ◽  
Lower Limbs ◽  
Vitamin Supplementation ◽  
Axonal Polyneuropathy ◽  
Peripheral Polyneuropathy

Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.

scholarly journals Case Report: Extensive Dermatitis Secondary to Severe Malnutrition, Zinc and Vitamin Deficiencies After Malabsorptive Bariatric Surgery

2021 ◽  
Vol 12 ◽  
Author(s):  
Aura D. Herrera-Martínez ◽  
Sonia Junquera-Bañares ◽  
Lucía Turrión-Merino ◽  
Francisco Arrieta-Blanco ◽  
José Botella-Carretero ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Case Report ◽  
Female Patient ◽  
Nutritional Deficiencies ◽  
Severe Malnutrition ◽  
Vitamin Deficiencies ◽  
Post Bariatric Surgery ◽  
Symptoms And Signs

Bariatric surgery is one of the most effective treatments currently available for obesity and its derived comorbidities. However, complications may occur, especially when malabsorptive surgeries like a biliopancreatic diversion is performed. We present the case of a female patient whose obesity was treated with this technique, and in the 9th year of follow-up developed an extensive dermatitis secondary to zinc deficiency and malnutrition, precipitated by therapeutic non-compliance. A close surveillance of early symptoms and signs of nutritional deficiencies as well as chronic supplementation of vitamins and trace elements is required; this case illustrates the relevance of periodical, lifelong visits to a medical physician with special training and experience in the management of post bariatric surgery patients in order to prevent, diagnosis and early treat related complications.

EP.WE.824Effect of bariatric surgery on gut permeability in humans: a systematic review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
James O'Brien ◽  
Denise Robertson ◽  
Bruce Griffin ◽  
Timothy Rockall ◽  
Chris Pring
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Intestinal Permeability ◽  
Meta Analysis ◽  
Oral Intake ◽  
Permeability Change ◽  
Before And After ◽  
Small Intestinal ◽  
Malabsorptive Operations

Abstract Aims Altered intestinal permeability (“leaky gut”) is associated with obesity. Several mechanisms have been suggested to explain the harmful sequalae that follow permeability change such as inflammation, alteration to the microbiome and onset of insulin resistance. Studies describe bariatric surgery as having varying effects on intestinal permeability. We aim to summarise and review the literature. Methods A systematic review was performed using MEDLINE, EMBASE, and Scopus to identify studies in humans that investigated permeability change after bariatric surgery. Results 5 studies were identified, all cohort. Heterogeneity precluded meta-analysis. All calculated permeability change following oral intake of different sugar solutions. Two studies described a reduction in gastroduodenal permeability post sleeve gastrectomy (SG), one from an increased baseline compared to lean controls. Two described an increase in small intestinal permeability after “malabsorptive” operations (biliopancreatic diversion and duodenal switch). Two found decreased small intestinal permeability at one month post Roux-en-Y gastric bypass and six months post SG. One including only SG had opposite findings of increased small intestinal permeability at 6 months. The only colonic change reported was increased permeability also 6 months post SG. Conclusion Research found both increased and decreased permeability of the small intestine. Two studies found reduced gastroduodenal permeability post operatively. Evidence regarding the effect of bariatric surgery on the permeability of the gastrointestinal tract and specifically the colon is limited and follow up, operation type and small numbers limit meaningful comparison. Further study into this crucial aspect of obesity both before and after surgery is needed.

scholarly journals Should bariatric surgery be performed in adolescents?

2017 ◽  
Vol 176 (4) ◽  
pp. D1-D15 ◽  
Author(s):  
Andrew J Beamish ◽  
Thomas Reinehr
Keyword(s):  
Bariatric Surgery ◽  
Severe Obesity ◽  
Treatment Strategies ◽  
Adolescent Obesity ◽  
Nutritional Deficiencies ◽  
Therapeutic Outcomes ◽  
Compliance To Treatment ◽  
Adolescent Bariatric Surgery

Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.

scholarly journals Third reported case of rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-En-Y gastric bypass: case report and literature review

2021 ◽  
Author(s):  
Yassmin Salaheldin ◽  
Walid El Ansari ◽  
Esraa Aljaloudi ◽  
Wahiba Elhag
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Risk Factor ◽  
Case Report ◽  
Zinc Deficiency ◽  
Nutritional Deficiencies ◽  
Level Of Evidence ◽  
Necrolytic Migratory Erythema ◽  
High Index Of Suspicion

Abstract Introduction Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. Case report We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). Conclusion Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. Level of evidence Level V, case report.

scholarly journals Intraoral Approach Drainage of Submasseteric Abscess in a 14-Month-Old Child

2019 ◽  
Vol 3 (2) ◽  
pp. 123
Author(s):  
Norsyamira Aida Mohamad Umbaik ◽  
Nik Syahrul Hafizzi ◽  
Nik Khairani Nik Mohamad ◽  
Hashimah Ismail ◽  
Irfan Mohamad
Keyword(s):  
Oral Intake ◽  
Health Sciences ◽  
Intraoral Approach ◽  
Contrast Enhanced ◽  
Anatomical Relationship ◽  
Poor Oral Intake ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Cheek Swelling

Submassteric abscess is a rare head and neck abscess. It may mimic a parotid abscess due to very close anatomical relationship. We present a 14-month-old child presented with fever, poor oral intake, irritability, and left-sided cheek swelling. Contrast-enhanced computed tomography of the neck showed an abscess formation in left submasseteric space. Intraoral drainage of abscess was successfully performed under general anesthesia. Patient recovered well and was discharged on day three post operatively. Subsequent follow up at one-week post operatively showed no recollection of the abscess.International Journal of Human and Health Sciences Vol. 03 No. 02 April’19. Page: 123-125

Sign in / Sign up

Export Citation Format

Share Document