Maintenance of Multivitamin Supplements After Sleeve Gastrectomy

Ruíz-Tóvar, Jaime; Llavero, Carolina; Zubiaga, Lorea; Boix, E.

doi:10.1007/s11695-016-2084-5

Cited by 30 publications

(22 citation statements)

References 14 publications

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“…We found lowered vitamin B1 levels in nine patients (7.3%) throughout the study period, but none showed clinical symptoms. This differs from RYGB patients in whom such deficiencies hardly occur [7,8]. Theoretically, this could be explained by the higher risk of minimized intake and vomiting after SG compared to a RYGB.…”

Section: Vitamin B1 Deficiencymentioning

confidence: 84%

“…There are several factors that put patients at risk for developing nutritional deficiencies after SG, including reduced food intake, decreased hydrochloric acid and intrinsic factor secretion, vomiting, poor food choices, and food intolerance [7,21]. Yet, others believe that SG has minimal impact on nutrient status [3] and that maintenance of MVS more than 3 months postoperatively seems to be of no benefit [8]. According to Ruiz-Tovar et al, once a patient is able to eat all kinds of food, additional vitamin and mineral supplementation can be discontinued [8].…”

Section: Discussionmentioning

confidence: 99%

“…Yet, others believe that SG has minimal impact on nutrient status [3] and that maintenance of MVS more than 3 months postoperatively seems to be of no benefit [8]. According to Ruiz-Tovar et al, once a patient is able to eat all kinds of food, additional vitamin and mineral supplementation can be discontinued [8]. In the present study, about three-quarters of the patients showed at least one micronutrient deficiency during the first year post-sleeve, despite the use of multivitamin supplements.…”

Section: Discussionmentioning

confidence: 99%

“…Since the anatomy of the intestinal tract remains unaltered when performing an SG, the risk of developing deficiencies is theoretically considered lower [7]. Some authors even state that an SG has minimal impact on nutrient status [3] and taking multivitamin supplements (MVS) for more than 3 months postoperatively is unnecessary [8]. However, short and midterm studies found that in SG patients, deficiencies are as common as in RYGB patients [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT

et al. 2019

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Background Since a few years, the laparoscopic sleeve gastrectomy (SG) has become the most performed bariatric operation worldwide. However, as with all bariatric procedures, SG also leads to vitamin and mineral deficiencies post-operatively and standard multivitamin supplements are probably not sufficient. Objective The present study evaluates the effectiveness of a specialized multivitamin supplement for SG patients (WLS Optimum 1.0, FitForMe, Rotterdam, the Netherlands), compared to a standard multivitamin supplement (sMVS). Design A double-blind randomized controlled trial was performed. For 12 months, patients in the intervention group received WLS Optimum, containing elevated doses of multiple vitamins and minerals. Patients in the control group were provided with sMVS, containing 100% of the recommended dietary allowance. Results In total, 139 patients were available for analysis (WLS Optimum, n = 69; sMVS, n = 70). Intention-to-treat analyses revealed more folic acid deficiencies and higher serum vitamin B1 levels in the WLS Optimum group. Per protocol analyses showed that in patients using WLS Optimum, serum folic acid and vitamin B1 levels were higher, serum PTH levels were lower, and only one patient (2.6%) was anemic compared to 11 patients (17.5%) using a sMVS (p < 0.05 for all). No differences were found in prevalence of deficiencies for iron, vitamin B12, vitamin D, and other vitamins and minerals. Conclusions This optimized multivitamin supplement only affected serum levels of folic acid, PTH and vitamin B1, and anemia rates compared to a sMVS. There is a clear need to further optimize multivitamin supplementation for SG patients. Besides, noncompliance with multivitamin supplements remains an important issue that should be dealt with. Clinical Trial Registry The study protocol was registered at the clinical trials registry of the National Institutes of Health (ClinicalTrials.gov; identifier NCT01609387).

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Section: Vitamin B1 Deficiencymentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT

et al. 2019

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“…Although RYGB was found to be the gold standard procedure, the most commonly performed procedure in many countries is currently the sleeve gastrectomy [22,23]. Laparoscopic sleeve gastrectomy is a restrictive procedure that is characterized by the removal of most of the fundus of the stomach without alteration of intestinal absorption; it is considered to be relatively safe with low morbidity [24,25,26]. The changes of the gastrointestinal tract resulting from such interventions are supposed to also affect the absorption of orally administered drugs.…”

Section: Introductionmentioning

confidence: 99%

Oral Contraceptives after Bariatric Surgery

Schlatter

2017

Obes Facts

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Objective: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. Methods: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. Results: The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters. Bariatric surgery could potentially result in a transient change in the absorption of drugs such as analgesics, antibiotics, antiarrhythmics, anticoagulants, psychotropic, and oral contraceptive drugs. Effective contraception is especially critical in the postoperative period, and implants might be representing a safe contraceptive method in women undergoing bariatric surgery. Conclusion: Each drug will have to be evaluated with respect to its site of absorption and its mechanism of absorption, with special attention on parameters influencing the effectiveness of the absorption processes.

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