Skip to main content

Advertisement

Log in

Prevalence of Iron, Folate, and Vitamin B12 Deficiency Anemia After Laparoscopic Roux-en-Y Gastric Bypass

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

One of the most common bariatric operations is the laparoscopic Roux-en-Y gastric bypass (LRYGBP) in which the gastric capacity is restricted and the absorption by the small intestine is reduced. The objective of this study was to evaluate the incidence of iron, folate, and vitamin B12 deficiency anemia in patients undergoing LRYGBP.

Patients and methods

Clinical records of 30 patients who underwent LRYGBP between July 2003 and January 2005 and had a minimum follow up of 24 months at our outpatient clinic were included. Multivitamin supplementation was prescribed to all patients. The complete blood cell count, plasma iron, total iron-binding capacity, transferrin saturation, serum folate, and cobalamin levels before surgery, 6 months, 1, 2, and 3 years after the surgery were analyzed.

Results

There were 25 women (83.4%) and five men (16.6%) with ages from 21 to 56 years. Before surgery, two patients (6.6%) presented ferropenic anemia. Iron deficiency was seen in 40 and 54.5% 2 and 3 years after surgery, respectively. Cobalamin deficiency was observed in 33.3% at 2 years and in 27.2% at 3 years. At 2-year follow-up, 46.6% of the patients had already developed anemia and 63.6% at 3 years. Folate deficiency was not observed in any patient.

Conclusion

Our routine scheme of vitamin supplementation is not sufficient to prevent iron and vitamin B12 deficiencies in most patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Virji A, Murr MM. Caring for patients after bariatric surgery. Am Fam Phys. 2006;73:1403–8.

    Google Scholar 

  2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  3. Sjostrom L, Lindroos A, Peltonen M, et al. Lifestyle, diabetes and cardiovascular risk factors 10 years alter bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  4. Alvarez-Leite JI. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7:569–75.

    Article  PubMed  Google Scholar 

  5. Parkes E. Nutritional management of patients after bariatric surgery. Am J Med Sci. 2006;331(4):207–13.

    Article  PubMed  Google Scholar 

  6. Piedras Ros J, Reyes Devesa S, et al. Limites de referencia de serie roja obtenidos en Equipo Coulter S plus STK R en adultos sanos residentes a 2240 metros sobre nivel del mar. Rev Invest Clin. 1991;43:174–8.

    PubMed  CAS  Google Scholar 

  7. Guerrero Mayares P, Halabe Cherem J. Diagnóstico de las anemias. Med Int Mex. 2004;20:124–9.

    Google Scholar 

  8. Malindowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci. 2006;33(14):219–25.

    Article  Google Scholar 

  9. Mott T. How effective is gastric bypass for weight loss? J Fam Pract. 2004;53(11):914–7.

    PubMed  Google Scholar 

  10. Crowley LV, Seay J, Mullin G. Late effects of gastric bypass for morbid obesity. Am J Gastroenterol. 1984;79:850–60.

    PubMed  CAS  Google Scholar 

  11. Mason ME, Jalagani H, Vinik AI. Metabolic complications of bariatric surgery: diagnosis and management issues. Gastroenterol Clin North Am. 2005;34:25–33.

    Article  PubMed  Google Scholar 

  12. Livingston EH. Complications of bariatric surgery. Surg Clin North Am. 2005;85:853–68.

    Article  PubMed  Google Scholar 

  13. Kaplan LM. Gastrointestinal management of the bariatric surgery patient. Gastroenterol Clin North Am. 2005;34:105–25.

    Article  PubMed  Google Scholar 

  14. Brehrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci. 1994;39(2):315–20.

    Article  Google Scholar 

  15. Ponsky TA, Brody F, Pucci E. Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass. J Am Coll Surg. 2005;201(1):125–31.

    Article  PubMed  Google Scholar 

  16. Halverson JD, Zuckerman, GR Koheler RE, et al. Gastric bypass for morbid obesity. A medical–surgical assessment. Ann Surg. 1981;194:152–60.

    Article  PubMed  CAS  Google Scholar 

  17. Amaral JF, Thompson WR, Caldwell MD, et al. Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg. 1985;201:186–93.

    Article  PubMed  CAS  Google Scholar 

  18. Borlin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.

    Article  Google Scholar 

  19. Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Obes Surg. 2002;12:551–8.

    Article  PubMed  Google Scholar 

  20. Rhode BM, Shustick C, Christou NV, et al. Iron absorption and therapy after gastric bypass. Obes Surg. 1999;9:17–21.

    Article  PubMed  CAS  Google Scholar 

  21. Stocker DJ. Management of the bariatric surgery patient. Endocrinol Metab Clin North Am. 2003;32:437–57.

    Article  PubMed  Google Scholar 

  22. Fujioka K. Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005;28:481–4.

    Article  PubMed  Google Scholar 

  23. Brolin RE, Leung M. Survey of vitamin and mineral supplementation alter gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–4.

    Article  PubMed  CAS  Google Scholar 

  24. Borlin RE, Gorman JH, Gorman RC, et al. Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study. Arch Surg. 1998;122:740–4.

    Google Scholar 

  25. Mallory GN, Macgregor AM. Folate status following gastric bypass surgery (the great folate mystery). Obes Surg. 1991;1:69–72.

    Article  PubMed  Google Scholar 

  26. Xanthakos SA, Inge TH. Nutritional consequences of bariatric surgery. Curr Opin Clin Nutr Metab Care. 2006;9:489–96.

    Article  PubMed  CAS  Google Scholar 

  27. Dunlevy LP, Chitty LS, Burren KA. Abnormal folate metabolism in foetuses affected by neural tube defects. Brain. 2007;130:1043–9.

    Article  PubMed  Google Scholar 

  28. Czeizel AE, Dudas I. Prevention of the first occurrence of neural tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327;1832–5.

    Article  PubMed  CAS  Google Scholar 

  29. Woodard CB. Pregnancy following bariatric surgery. J Perinat Neonatal Nurs. 2004;18:329–40.

    PubMed  Google Scholar 

  30. Decker GA, Swain JM, Crowell MD. Gastrointestinal and nutritional complications after bariatric surgery. Am J Gastroenterol. 2007;102:1–10.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gabriela Hernández-Rivera.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vargas-Ruiz, A.G., Hernández-Rivera, G. & Herrera, M.F. Prevalence of Iron, Folate, and Vitamin B12 Deficiency Anemia After Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 18, 288–293 (2008). https://doi.org/10.1007/s11695-007-9310-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9310-0

Keywords

Navigation