Researchers warn that gastric bypass surgery may cause post-op nutrient deficienciesOctober 15, 2007Two studies by a group of researchers at Washington Hospital Center highlight potential postoperative nutritional deficiencies among patients who undergo gastric bypass surgery to treat obesity. Research presented at the 72nd Annual Scientific Meeting of the American College of Gastroenterology by Dr. Frederick Finelli and Dr. Timothy Koch suggests that a potentially serious condition can emerge after gastric bypass surgery known as small intestinal bacterial overgrowth that has an impact on absorption of vitamins, minerals and micronutrients such as calcium and zinc. According to the Washington Hospital Center team, this is a serious issue with widespread implications as approximately 150,000 patients this year will have gastric bypass surgery, and there exists wide variation in surgical techniques. According to Dr. Koch, "patients may develop bacterial overgrowth that interferes with their ability to absorb nutrients, even if they are taking supplements as directed after surgery. Only a gastroenterologist can evaluate these potentially serious small intestinal disorders." Dr. Koch and his colleagues hypothesized that by altering the gut ecology, gastric bypass surgery could induce calcium deficiency. Surgical changes to the stomach to create the "gastric pouch" in the Roux-en-Y procedure impact the number of acid producing cells in the stomach lining. Furthermore, many gastric bypass patients are given acid suppressing drugs after their surgery. Researchers suspect that the reduction in acid, known as achlorhydria, contributes to the overgrowth of bacteria in the small intestine. According to Dr. Koch, competition between bacteria and the human host for ingested nutrients leads to malabsorption and potentially serious complications due to micronutrient deficiency. In the studies presented at the ACG, Dr. Koch's team found that in a retrospective review of gastric bypass patients, almost all of the 43 patients who had hydrogen breath testing for small intestinal bacterial overgrowth ("SIBO") had abnormal findings. Researchers also measured levels of calcium and found that those with SIBO had lower calcium levels. Researchers warn that calcium malabsorption may increase the risk for developing osteopenia (low bone mineral density), osteoporosis (a progressive bone loss that may increase the risk of fractures), or osteomalacia (softening of the bones due to defective bone mineralization.) In a second study, Dr. Koch and his colleagues reviewed that same group of patients to examine the relationship between SIBO and zinc deficiencies, and found a positive correlation. In the case of zinc absorption, the physiological evidence supports zinc absorption in the jejunum by a trancellular route involving a zinc-specific transporter, Zip4. In the Roux-en-Y procedure, surgeons make the stomach smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum). Dr. Koch explained that the wide variation in surgical techniques for gastric bypass means that patients should be aware of the risk of problems absorbing nutrients, and should consult with a gastrointestinal specialist. American College of Gastroenterology |
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| Related Gastric Bypass Current Events and Gastric Bypass News Articles NIH study finds low short-term risks after bariatric surgery for extreme obesity Short-term complications and death rates were low following bariatric surgery to limit the amount of food that can enter the stomach, decrease absorption of food or both, according to the Longitudinal Assessment of Bariatric Surgery (LABS-1). Study: Bariatric surgery patients have 67 percent lower chance of complications at top hospitals The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals. Probiotics help gastric-bypass patients lose weight more quickly, Stanford study shows New research from the Stanford University School of Medicine and Stanford Hospital & Clinics suggests that the use of a dietary supplement after Roux-en-Y gastric bypass surgery can help obese patients to more quickly lose weight and to avoid deficiency of a critical B vitamin. Lap-band weight-loss surgery can reverse metabolic syndrome in obese teens A new study of obese adolescents has shown that laparoscopic gastric banding surgery -- the "Lap-Band" procedure -- not only helps them achieve significant weight loss but can also improve and even reverse metabolic syndrome, reducing their risk for cardiovascular disease and diabetes. Roux-en-Y weight loss surgery raises kidney stone risk The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study. Fatty foods -- not empty stomach -- fire up hunger hormone New research led by the University of Cincinnati (UC) suggests that the hunger hormone ghrelin is activated by fats from the foods we eat-not those made in the body-in order to optimize nutrient metabolism and promote the storage of body fat. Study shows potential for resolving type 2 diabetes with bariatric surgery As the incidence of obesity-induced type 2 diabetes mellitus continues to increase worldwide, medical research indicates that surgery to reduce obesity can completely eliminate all manifestations of diabetes. Obesity linked to hormone imbalance that impacts sexual quality of life Hormonal changes and diminished sexual quality of life among obese men are related to the degree of obesity, and both are improved after gastric bypass surgery according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). Our microbes, ourselves In terms of diversity and sheer numbers, the microbes occupying the human gut easily dwarf the billions of people inhabiting the Earth. Numbering in the tens of trillions and representing many thousands of distinct genetic families, this microbiome, as it's called, helps the body perform a variety of regulatory and digestive functions, many still poorly understood. Sealing off portion of intestinal lining treats obesity, resolves diabetes in animal model Lining the upper portion of the small intestine with an impermeable sleeve led to both weight loss and restoration of normal glucose metabolism in an animal model of obesity-induced diabetes. More Gastric Bypass Current Events and Gastric Bypass News Articles |
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