Skip to main content

Advertisement

Log in

Need for Multivitamin Use in the Postoperative Period of Gastric Bypass

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

Abstract

Background

Based on the reduced gastric volume and the malabsorption produced by Roux-en-Y gastric bypass (RYGBP) and diet therapy, it is essential in the postoperative period to obtain and maintain an adequate nutritional state, with the aim of preventing malnutrition and seeking a healthy life. It is observed that patients have difficulty in understanding the new food choices that must considered, as they have eating habits that are very divergent from those currently proposed. There is often the need for vitamin and mineral replacement after laboratory tests.

Methods

This study calculated and evaluated the 24-h eating records of 210 patients, collected in the course of nutritional visits in follow-ups of the first, third, sixth, ninth, 12th, 18th, and 24th months postoperative.

Results

It was possible to observe an increase in the consumption of nutrients in the course of the study period, but it was not regular and significant for all the nutrients. Also, it is noted that the minimal requirements for vitamin A, vitamin C, calcium, iron and B-complex vitamins (except for cyanocobalamin and riboflavin) were not attained. The nutrients in which satisfactory results were obtained were total proteins of high biological value: cyanocobalamin and riboflavin.

Conclusion

This study demonstrated the concern for nutrient supplementation in the postoperative period of RYGBP. Thus, the routine use of multivitamins is deemed necessary after the first month postoperatively, with its maintenance preferably for the rest of the patient’s life, without abandoning periodic clinical and laboratory follow-up.

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.

Similar content being viewed by others

References

  1. Deitel M. Overweight and obesity worldwide now estimated to involve 1.7 billion peopple. Obes Surg 2003;13:329–30.

    Article  PubMed  Google Scholar 

  2. Buchwald H. The future of bariatric surgery. Obes Surg 2005;15:598–605.

    Article  PubMed  Google Scholar 

  3. Fobi MA. Surgical treatment of obesity—a review. J Natl Med Assoc 2004;96:61–75.

    PubMed  CAS  Google Scholar 

  4. Fernandes LC, Pucca L, Matos D. Tratamento cirúrgico da obesidade. Jornal Brasileiro de Medicina 2001;80:44–8.

    Google Scholar 

  5. Rhode BM. Vitamin and mineral supplementation after gastric bypass. In: Deitel M, Cowan GSM Jr, editors. UP DATE: surgery for the morbidly obese patient. Toronto: F-D Communications; 2000. p. 161–70.

    Google Scholar 

  6. Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg 2007;17:1150–8.

    Article  PubMed  CAS  Google Scholar 

  7. Dalcanale L, Quadros MRR. Analise estatística da variação do estado nutricional no pré e pós-operatório de cirurgia bariátrica. anais do simpósio internacional: temas atuais na prevenção e tratamento da obesidade, Florianópolis; 2003. 11.

  8. Crowley LV, Seay J, Mullin G. Late effects of gastric bypass for obesity. J Gastroenterol 1984;79:11–15.

    Google Scholar 

  9. Grace DM. Metabolic complications following gastric restrictive procedures. In: Deitel MC, editor. Surgery for the morbidly obese patient. Portland: Bookmens; 1989. p. 339–50.

    Google Scholar 

  10. Rojas-Marcos PM, Rubio MA, Kreskshi WI, et al. Severe hypocalcemia following total thyroidectomy after biliopancreatic diversion. Obes Surg 2005;15:431–34.

    PubMed  Google Scholar 

  11. Ybarra J, Sanches-Hernandez J, Gich I, et al. Unchanged Hypovitaminosis and secondary hyperparathyroidism in morbid obesity after bariatric surgery. Obes Surg 2005;15:330–5.

    PubMed  Google Scholar 

  12. Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg 2005;15:145–54.

    Article  PubMed  Google Scholar 

  13. Escalona A, Perez G, Leon F, et al. Wernicke’s encephalopathy after Roux-en-Y gastric bypass. Obes Surg 2004;14:1135–7.

    Article  PubMed  Google Scholar 

  14. Alves LFA, Gonçalves RM, Cordeiro GV, et al. Beribéri pos bypass gástrico: uma complicação não tão rara. Relato de dois casos e revisão de literatura. Arq bras Endocrinol Metab 2003;50:564–8.

    Google Scholar 

  15. Machado FCN, Valerio BCO, Morgulius RNF, et al. Polineuropatia axonal aguda com acometimento proximal predominante: manifestation neurologica incomum de cirurgia bariátrica. Arq Neuro-Psiquiatr 2006;64:609–12.

    Article  Google Scholar 

  16. Thaisetthawatkul P, Collazzo-Clavell ML, Sarr MG, et al. A controlled study of peripheral neurophathy after bariatric surgery. Neurology 2004;63:1462–70.

    PubMed  CAS  Google Scholar 

  17. Koffman BM, Greenfield LJ, Ali LL, et al. Neurologic complications after surgery for obesity. Muscle Nerve 2006;33:166–76.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Malinowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci 2006;331:219–25.

    Article  PubMed  Google Scholar 

  20. Casagrande DS, Colossi FG, Rizzoli J, et al. Terapia nutricional para pacientes submetidos à cirurgia bariátrica no centro de obesidade mórbida do hospital São Lucas da PUC/RS. Boletim de Cirurgia da Obesidade 2001;2:7.

    Google Scholar 

  21. Faria OP, Pereira V, Gangoni CMC, et al. Obesos mórbidos tratados com gastroplastia redutora com bypass gástrico em y de roux: análise de 160 pacientes. Boletim de Cirurgia da Obesidade 2001;2:15–7.

    Google Scholar 

  22. National Academy of Sciences. Dietary Reference Intakes—DRI reports 2004. http://www.nap.edu.

  23. Mango VL, Frishman WH. Physiologic, psychologic, and metabolic consequences of bariatric surgery. Cardiol Rev 2006;14:232–7.

    Article  PubMed  Google Scholar 

  24. Quadros MRR, Filho AJB, Zacarias J. A analise da evolução dietética no pós-operatório de cirurgia bariátrica. Revista Nutrição em Pauta 2005;6:13–5.

    Google Scholar 

  25. Leite JIA. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care 2004;7:569–75.

    Article  Google Scholar 

  26. Colossi FG, Casagrande DS, Rizzoli J, et al. Nutrient supplementation after bariatric surgery—oral presentation—abstract of the World Congress of Obesity Surgery, IFSO in Maastricht. Obes Surg 2005;15:929.

    Article  Google Scholar 

  27. Colossi FG, Casagrande DS, Chatkin R, et al. Need for multi-vitamin use in post-operative period of Roux-en-Y gastric bypass—oral presentation—abstract of the World Congress of Obesity Surgery, IFSO in Porto/Portugal. Obes Surg 2007;17:1031–2.

    Google Scholar 

  28. Reistein CS. DIETWIN Professional [software de nutrition]. Versão 2.0 for Windows. Porto Alegre, RS; 2003.

  29. Guy HS, Christine JR, Niccole S, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsortive bariatric surgery. The Society for Surgery of the Alimentary Tract 2004;5:48–55.

    Google Scholar 

  30. Hamoui N, Anthone G, Crooks PF. Calcium metabolism in the morbidly obese. Obes Surg 2004;14:9–12.

    Article  PubMed  Google Scholar 

  31. Newbury L, Dolan K, Hatzifotis M, et al. Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion. Obes Surg 2003;13:893–5.

    Article  PubMed  Google Scholar 

  32. Diniz M de F, Diniz MT, Sanches SR, et al. Elevated serum parahormone after Roux-em-Y gastric bypass. Obes Surg 2004;14:1222–6.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  34. Shikora SA. Surgical treatment for severe obesity: the state of the art for the new millennium. Nutr Clin Pract 2002;15:13–22.

    Article  Google Scholar 

  35. Waitzberg DL e col. Nutrição oral, enteral e parenteral na prática clínica. 3rd ed. São Paulo: Atheneu; 2000.

  36. Foster D, Falah M, Kadom N, et al. Wernicke encephalopathy after bariatric surgery: loosing more than just weight. Neurology 2005;65:1987–91.

    Article  PubMed  CAS  Google Scholar 

  37. Chang CG, Adams-Hurst B, Provost DA. Acute post gastric reduction surgery (APGARS) neuropathy. Obes Surg 2004;14:182–9.

    Article  PubMed  Google Scholar 

  38. Loy Y, Watson WD, Verma A, et al. Acute Wernicke’s encephalopathy following bariatric surgery: clinical course and MRI correlation. Obes Surg 2004;14:129–32.

    Article  Google Scholar 

  39. Brolin 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  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cláudio C. Mottin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Colossi, F.G., Casagrande, D.S., Chatkin, R. et al. Need for Multivitamin Use in the Postoperative Period of Gastric Bypass. OBES SURG 18, 187–191 (2008). https://doi.org/10.1007/s11695-007-9384-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9384-8

Keywords

Navigation