Su1888 Mucosal Sucrase Activity Is Diminished Following Bariatric Roux-en-Y Surgery

Opekun, Antone R.; Fracolli, Katie; Brandt, Mary L.; Sherman, Vadim; Hernandez, Karol; Chumpitazi, Bruno P.

doi:10.1016/s0016-5085(14)61777-7

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“…In 50% of bypass patients (secondary) lactase deficiency may develop, or an existing minor deficiency may manifest post‐operatively . In a most recently presented pilot study, Opekun and colleagues reported for the first time impaired effectivity of intestinal sucrase, a trypsin‐activated enzyme, in patients who had undergone RYGB surgery, evidenced by aC‐sucrose/glucose breath test.…”

Section: Methodsmentioning

confidence: 99%

Review article: the nutritional and pharmacological consequences of obesity surgery

Stein

Stier

Raab

et al. 2014

Aliment Pharmacol Ther

228

130

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SUMMARY BackgroundObesity surgery is acknowledged as a highly effective therapy for morbidly obese patients. Beneficial short-term effects on common comorbidities are practically undisputed, but a growing data pool from long-term follow-up reveals increasing evidence of potentially severe nutritional and pharmacological consequences. AimsTo assess the prevalence, causes and symptoms of complications after obesity surgery, to elucidate and compare therapy recommendations for macro-and micronutrient deficiencies, and to explore surgically-induced effects on drug absorption and bioavailability, discussing ramifications for long-term therapy and prophylaxis. MethodsPubMed, Embase and MEDLINE were searched using terms including, but not limited to, bariatric surgery, gastric bypass, obesity surgery and Roux-en-Y, coupled with secondary search terms, e.g. anaemia, micronutrients, vitamin deficiency, bacterial overgrowth, drug absorption, pharmacokinetics, undernutrition. All studies in English, French or German published January 1980 through March 2014 were included. ResultsMacro-and micronutrient deficiencies are common after obesity surgery. The most critical, depending on surgical technique, are hypoalbuminemia (3-18%) and deficiencies of vitamins B 1 (≤49%), B 12 (19-35%) and D (25-73%), iron (17-45%) and zinc (12-91%). Many drugs commonly administered to obese patients (e.g. anti-depressants, anti-microbials, metformin) are subject to post-operative and/or PPI-associated changes affecting bioavailability and absorption. ConclusionsComplications are associated with pre-operative and/or post-operative malnutrition or procedure-related changes in intake, absorption and drug bioavailability. The high prevalence of nutrient deficiencies after obesity surgery makes life-long nutritional monitoring and supplementation essential. Post-operative changes to drug absorption and bioavailability in bariatric patients cast doubt on the validity of standard drug dosage and administration recommendations.

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Section: Methodsmentioning

confidence: 99%