Guideline to prevent and treat nutritional deficiencies after Roux-en-Y Gastric Bypass
The Roux-en-Y Gastric Bypass is commonly associated with nutritional deficiencies and requires life-long supplementation. To bring guidance into nutritional healthcare for this patient group, a literature review was conducted. This review lead to a new approach to prevention and management of nutritional deficiencies and a guideline for supplementation after a Gastric Bypass.
Guideline on supplementation dosages
The review found that the prevention strategy for every Gastric Bypass patient should include a multivitamin containing at least 200% of the daily recommended value, 400 mcg of folic acid and 18 mg of iron. Furthermore, vitamin A, vitamin B12, vitamin D, calcium, zinc and copper should be supplemented in a dosage tailored to the patients’ specific needs. For a complete overview of dosage advice in the guideline on supplementation after a Gastric Bypass, see table 1.
Monitoring on deficiencies after a Gastric Bypass
Some bariatric patients may require additional supplementation of one or more vitamins and minerals. Patients should be monitored carefully and frequently. To ensure optimal deficiency prevention and treatment, patients should be made aware of the importance of proper nutrition and compliance with supplementation.
Table 1: Prevalence and advice for nutritional deficiencies after a Gastric Bypass
|Nutrient||Deficiency prevalence||Supplementation advice for deficiency prevention|
|Vitamin B12||26-70%||1000 mcg orally or sublingually|
|Folate||9-38%, higher prevalence among pregnant women||800-1000 mccg|
|Iron||6-52%, higher prevalence among menstruating or pregnant women||36-65 mg, higher doses for menstruating women and people at risk for anemia|
|Calcium||10% 2 years post-op||1.700-2.000 mg from both diet and supplementation|
|Vitamin D||50-80%||1.000-2.000 IU|
|Vitamin A||11%||10.000-25.000 IU|
|Zinc||36%||More research needed to identify the optimal supplementation dose|
|Copper||18,8%||No current recommendations|
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Levinson, R., Silverman, J.B., Catella, J.G. et al. (2013) Pharmacotherapy prevention and management of nutritional deficiencies post Roux-en-Y gastric bypass. OBES SURG (2013) 23: 992. https://doi.org/10.1007/s11695-013-0922-2
Link to full text: https://link.springer.com/article/10.1007%2Fs11695-013-0922-2