Incidence and risk factors for the development of anemia following gastric bypass surgery

Abstract

Iron deficiency anemia is frequent. RYGB surgery compounds occult blood loss. Increased ferrous sulfate supplementation may prevent iron depletion in populations at increased risk.

Malabsorption anemia and iron supplement induced constipation in post-Roux-en-Y gastric bypass (RYGB) patients

“…Later onset anemia typically occurs from 8 weeks to 2 years postoperatively and results from the depletion of iron, folate, and vitamin B12 stores. Late onset anemia has been reported in patients up to 7-10 years postoperatively (Avgerinos et al, 2010;Harbottle, 2011;Mechanick et al, 2009). Iron deficiency has been reported in up to 50% of women who have had the RYGB procedure with a greater risk for anemia occurring in menstruating women.…”

“…Iron deficiency has been reported in up to 50% of women who have had the RYGB procedure with a greater risk for anemia occurring in menstruating women. Postsurgical iron deficiency has been attributed to a number of factors, in- cluding menstrual blood loss, diminished food intake and intolerance of iron-rich foods such as red meat, impaired conversion of ingested ferric iron to absorbable iron from the loss of gastric acid exposure, and the surgical bypass of the duodenum, which is predominately responsible for iron absorption (Avgerinos et al, 2010;Harbottle, 2011;Mechanick et al, 2009). In addition to malabsorption, iron store depletion can occur as a result of presurgical nutritional deficiencies commonly found in obese men and women (Marinella, 2008).…”

“…While significant surgical weight loss provides a dramatic opportunity to reverse obesity-related diseases, it also requires lifelong behavioral change to ensure therapeutic micronutrient supplementation, including iron. Iron deficiency anemia is a common sequela of RYGB estimated to occur in 6%-50% of post bypass patients (Avgerinos, Llaguna, Seigerman, Lefkowitz, & Leitman, 2010;Marinella, 2008;Vargas-Ruiz et al, 2008). Iron deficient anemia has been independently linked with increased inflammatory markers associated with atherosclerosis, increased cardiovascular event risk, and adverse cardiovascular outcomes in women (Arant et al, 2004).…”

“…Contemporary evidence suggests prophylactic iron supplementation with ferrous sulfate to prevent iron deficiency anemia (Avgerinos et al, 2010;Harbottle, 2011;Mechanick et al, 2009Mechanick et al, , 2013. Ferrous sulfate is a wellestablished iatrogenic cause of constipation and other unpleasant gastrointestinal side effects, often resulting in low patient tolerability and subsequent low adherence rates.…”

Komplikationen und metabolische Störungen nach bariatrischen Operationen aus gastroenterologischer Sicht

“…A routine lifelong interdisciplinary follow-up therapy should aim to avoid such deficient conditions in addition to the treatment of preexisting diseases. [5]). Letztere können einen Vita minB 12 Mangel vortäuschen [45,6].…”