title: Update on micronutrients in bariatric surgery.
abstract: OBJECTIVE
  Obesity is a growing worldwide epidemic. Obese patients are often deficient in micronutrients despite macronutrient excess. Bariatric surgery is an increasingly utilized modality in the treatment of obesity and obesity-related conditions. Bariatric surgery itself may cause or exacerbate micronutrient deficiencies with serious sequelae. This review will focus on perioperative strategies to detect, prevent and treat micronutrient deficiencies in patients undergoing bariatric surgery, and will highlight practical and clinical aspects of these nutritional problems.
  
  
  RESULTS
  Micronutrient deficiency is common in obese patients undergoing bariatric surgery both preoperatively and postoperatively. Bariatric procedures with a malabsorptive component are more likely to result in postoperative micronutrient deficiency. A system-based approach will facilitate clinical suspicion of specific or combined micronutrient deficiencies, leading to appropriate laboratory tests for confirmation. Supplementation by the oral route is always tried first, reserving parenteral administration for specific situations.
  
  
  CONCLUSIONS
  Clinicians should be aware that micronutrient deficiencies are common in obese patients who may have macronutrient excess. Micronutrient deficiency may exist preoperatively or be caused by bariatric procedures themselves. A systematic and team-based approach will decrease morbidity associated with delays in diagnosis and treatment.
authors: Division of Surgical Critical Care, Department of Surgery, Stroger Hospital of Cook County, Chicago, Illinois, USA.
authors: Daniel
authors: D
authors: Valentino
authors: Krishnan
authors: K
authors: Sriram
authors: Padmini
authors: P
authors: Shankar
mesh_terms: D000284:Administration, Oral; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D019587:Dietary Supplements; D019468:Disease Management; D006801:Humans; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control*; D018977:Micronutrients / Q000008:administration & dosage / Q000172:deficiency*; D009765:Obesity / Q000453:epidemiology* / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care / Q000379:methods
chemical_list: D018977:Micronutrients