Recommended nutritional supplements for bariatric surgery patients.
OBJECTIVE
To review nutritional supplements commonly required after bariatric surgery to provide a practical guide and reference source for generalist healthcare providers.


METHODS
A PubMed literature search (1988-July 2008) was conducted, using the search term nutritional deficiency after bariatric surgery, and was limited to English-language literature on adult (aged >19 y) human subjects. Additional references from the selected literature were also included.


METHODS
Data were extracted from large clinical series and practice guidelines whenever possible. Case reports were used only when they were the sole information source.


RESULTS
Nutritional deficiencies that occur after bariatric surgery depend significantly on the type of surgery performed. Restrictive procedures such as gastric banding are the least likely to cause nutritional deficits, since none of the intestine is bypassed. Malabsorptive procedures such as biliopancreatic diversion or mixed restrictive/malabsorptive procedures (eg, Roux-en-Y gastric bypass) can result in serious nutritional problems when patients do not take required supplements after surgery. Vitamins and minerals that are commonly deficient in this circumstance include vitamin B(12), calcium, vitamin D, thiamine, folic acid, iron, zinc, and magnesium. Rare ocular complications have been reported with hypovitaminosis A.


CONCLUSIONS
Healthcare professionals, especially those who practice outside large bariatric centers, must be aware of the supplements required by patients who have had bariatric surgery. Many patients fail to follow up with the surgery centers and are managed by their primary care teams and community pharmacists, especially in the selection of multivitamin and nutritional supplements.
Malone
Margaret
M
Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA. margaret.malone@acphs.edu
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D004032:Diet; D019587:Dietary Supplements; D006801:Humans; D009748:Nutrition Disorders / Q000209:etiology / Q000517:prevention & control*; D009751:Nutritional Requirements; D009765:Obesity / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D014815:Vitamins / Q000008:administration & dosage; D055815:Young Adult
D014815:Vitamins