Nutrition after Gastric Bypass

Anemia and a variety of other nutrition issues are very common after gastric bypass surgery. Here are some tips.
Deficiencies in fat soluble vitamins are common after bypass surgery. The fat soluble vitamins are Vitamins A, D, E and K. Calcium and iron absorption are also problematic. That leaves bariatric patients with an increased risk of anemia and osteoporosis.
The surgery results in a reduction in the acid that is most prevalent in the stomach, hydrochloric acid. That makes it very difficult to absorb calcium as calcium carbonate. Calcium citrate is much more available for absorption and is the preferred form of calcium in bariatric patients.
Iron is also not absorbed very well because the duodenum is bypassed and that is where iron is absorbed. If patients consume calcium with vitamin C (ascorbic acid), there is a greater chance that the iron will be absorbed in the stomach.
There are also some medications that might be a problem in bypass patients. For instance, there may be a delay in the effectiveness after taking ambien, a sleeping pill that usually works immediately. It may take a little longer to get those eyes closed for the night but the problem can be minimized if the ambien is taken on an empty stomach.
Zocor is another medication that may be problematic. Another statin may have to be used.
Niacin should be taken with a low-fat snack.
Ramipril and enalapril, common blood pressure medications may not be as effective as other angiotensin converting enzyme inhibitors and they may need to be substituted.
Metformin is also not absorbed well and glucose should probably be followed closely.
Finally, metoprolol is absorbed very quickly in the stomach and duodenum generally but given the weight loss that occurs with the bypass may mean that fewer blood pressure medications will be necessary.
B12 should be taken in sublingual forms, eliminating the problem of Vitamin B12 deficiency.
While we don’t need a mega-doses of Vitamins, bypass patients should definitely take a multi-vitamin every day in order to be sure that they don’t be come deficient.