Gastric bypass surgery for morbid obesity is well know to cause a short and long term anemia, vitamin B12 and vitamin D deficiency because of bypassing the duodenum.
We receive more and more patients after sleeve gastrectomy complaining of severe anemia and vitamin deficiency similar to the bypass patient if not taker their supplements.
What you think
In terms of vitamin B12 is seems to be the Intrinsic factor which is not suffeciently available in the remaining stomach. This is well observed. But also vitamin D deficiency and aemia are documented in literature. This seems a physiological issue but also a matter of a decreased food intake.
See https://www.ncbi.nlm.nih.gov/pubmed/24582411
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021197/
I hope this helps.
Karl-Heinz
We are seeing this in patients following many different gastric surgeries, particularly bariatric, and they are being followed with vitamin supplementation (B12 is administered SL or injectable) and appropriate follow-up testing to prevent poor post surgical healing process and ability to follow group, etc. follow through to be successful. GBH
It is a physiological effect of gastic bypass operation, patients must be iformed before operation. A lifelong observation and supplimentation If needed is recomendend once a year
Apart from the causes mentioned by Dr.Wagner, I would also like to mention that stomach is involved in very intricate ways with digestion and absorption of macro and micronutrients e.g. [a] The acid is involved in iron absorption by converting Fe 2+ to Fe 3+ in duodenum [b] Acid helps in proper pancreatic secretion for further digestion which may be hampered by higher pH, [c] Improper churning and mixing of food in stomach along with altered pH may itself cause malabsorption distally. What is now being observed with Bariatric gastric surgeries was previously observed with surgeries for duodenal ulcer like Polya gastrectomy or Billroth operation.
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