Gastric Bypass Malabsorption

When considering bariatric surgery, you should also be thinking about how the changes are going to affect you post-op. 

Bariatric procedures have high success rates. However, with any type of surgery there are always risks and complications that can be associated. Malabsorption is a potential gastric bypass surgery complication

Malabsorption may seem intimidating and challenging. However, new scientific research is surfacing every day in order to properly manage any malabsorption after bariatric surgery.

This article will assist you in understanding what malabsorption is and how to manage it. 

What is Malabsorption?

Malabsorption is a complication that can occur in individuals who have had bariatric surgery. Depending on the bariatric procedure performed, malabsorption can be more or less likely. This complication occurs due to anatomical changes made to the gastrointestinal tract where many nutrients are absorbed, in turn, severely effecting absorption. 

Symptoms of malabsorption include chronic diarrhea, bloating, gas, consistent weight loss, and steatorrhea. Long-term symptoms include excessive weight loss, muscle wasting, and in severe cases, nervous system damage. 

Malabsorption can lead to malnutrition that can occur when the body is unable to obtain enough vitamins and minerals in order to function properly, resulting in further complications and conditions. For example, malabsorption can impact gastric bypass and anemia.

Malabsorption and Gastric Bypass Surgery

Gastric bypass surgery involves anatomical changes to the gastrointestinal

tract. This process increases the risk of malabsorption following surgery. 

After a gastric bypass procedure, food bypasses most of the stomach and small intestine. These sections of the gastrointestinal tract are responsible for digestion and absorption of specific vitamins and minerals causing malabsorption.

As a result, this process aids in initial weight loss after the bariatric procedure by restricting the body from digesting and naturally absorbing food. 

Bariatric Surgeries that Cause Malabsorption

Restrictive Bariatric Surgery

Restrictive surgeries initiate weight loss by limiting the amount of food that is entering the stomach.

Restrictive bariatric surgeries include: 

  • Adjustable Gastric Band Surgeries
  • Sleeve Gastrectomy

Malabsorptive Bariatric Surgery

Malabsorptive surgeries aim to reduce the number of nutrients being absorbed by the body to facilitate weight loss. 

This happens when certain digestive enzymes are inhibited or when sections of the digestive tract are bypassed or shortened. 

An example would be how bariatric surgery works to treat diabetes. Alterations to the gastrointestinal tract that can cause malabsorption will also have an effect on the secretion of certain hormones and gut microbiota which play a role in the regulation of glucose-control systems. 

Malabsorptive bariatric surgeries include: 

  • Gastric Bypass Surgeries 
  • Duodenal Switch Surgeries

These two procedures combine restriction and malabsorption to have a greater effect on weight loss and obesity-related health conditions.

Combination surgeries can be more expensive, whereas purely restrictive surgeries are typically more affordable bariatric surgery options. 

Before deciding which option is the best for you, it is recommended to check which insurance companies cover bariatric surgery. 

Correcting Malabsorption After Gastric Bypass

Malabsorption is one of the potential complications of a gastric bypass years later. After a gastric bypass is performed, you will have issues with micronutrient absorption. 

This can lead to complications with vitamin and mineral deficiencies if preventative measures are not sustained. Nutrient intake needs to be carefully considered and monitored following the surgery. 

Guidelines are provided for bariatric patients in order to prevent any vitamin and mineral deficiencies. The importance of a bariatric specific multivitamin for life should be discussed with your healthcare provider, as supplementation is going to be required for life after any bariatric procedure. 

Dietary Changes That Help with Malabsorption

Prioritize Protein

To assist in proper healing after bariatric surgery, high protein is important. Weight loss after bariatric surgery includes more than just losing fat. Malabsorption is going to cause rapid weight loss that diminishes fat, water, and muscle. 

In order to build and maintain muscle, higher protein intake is recommended. This can also help support your metabolism considering protein preserves muscle tissue, which is more metabolically active than fat tissue.

If you are not consuming enough protein through dietary food sources, supplementing your diet with bariatric protein shakes and bariatric meal replacements will help you to achieve your daily nutrient requirements.

Digestive Support

Malabsorptive duodenal switch procedures can cause fat malabsorption. Many complications can be seen as a side effect of this including steatorrhea, malabsorption of fat-soluble vitamins (ADEK), and pancreatic insufficiency. 

Higher levels of fat-soluble vitamins will have to be supplemented in order to account for the malabsorption rate. Bariatric high ADEK multivitamins are formulated with higher levels of these vitamins specifically for duodenal switch patients. 

Digestive enzymes may be recommended by your healthcare provider if you are experiencing steatorrhea, pancreatic insufficiency, intermittent nutrient deficiencies, and gastrointestinal side effects due to malabsorption after bariatric surgery.

Probiotics are another way to help combat side effects of malabsorption by reducing gastrointestinal issues. There are many benefits of probiotics after weight loss surgery, such as increasing the absorption of vitamin B12, increasing metabolic balance to promote weight loss, and enhancing your immune response. 

Vitamin Supplements

Chewable vitamins for bariatric patients will be recommended initially after weight loss surgery and can even be recommended before surgery.

After duodenal switch surgery, you will likely be recommended a high bariatric ADEK multivitamin, calcium, and possible a B-complex if deemed necessary. 

Adding bariatric supplements to your diet will not slow down weight loss or prevent you from reaching your target weight. Consistency is key with supplementation after bariatric surgery. This will ensure that you are receiving enough essential vitamins and minerals in order to prevent common deficiencies. 

Nutrient-Dense Foods

Eating a diet that is rich in nutrients will increase vitamin and mineral intake, overall health and wellbeing.

Following a bariatric portion plate will ensure you are consuming a balanced diet with nutrient-dense food options. 

Remember, you are still getting vitamins and minerals through your dietary food intake. Supplements are required to further assist your dietary intake where you may be lacking and in order to compensate for any malabsorption. 

Gastric Bypass Malabsorption FAQs

When do I Start Taking Vitamins and Supplements After a Gastric Bypass?

Most surgeons will provide you with guidelines for diet and supplements according to the type of bariatric surgery you have had. 

It is generally advised to start with post-op vitamins and supplements as soon as possible. Some healthcare providers will even recommend supplements before surgery in order to correct any low levels or deficiency. This will optimize your recovery and support a healthy post-op bariatric journey. 

Any other medications should be discussed with your healthcare provider. You will require guidance on when to take any additional medications for gastric bypass and diabetes, acid reflux or GERD after bariatric surgery.

What are the Symptoms of Micronutrient Deficiencies After Bariatric Surgery?

Signs and symptoms may vary according to which micronutrient you are deficient in. It is best to have regular checkups and screenings with your healthcare provider to ensure you are not deficient in anything. Regular blood work is necessary.

Here are some generalized symptoms that may indicate deficiencies: 

  • Dizziness 
  • Shortness of breath 
  • Muscle weakness 
  • Blurred vision 
  • Headaches 

All of these signs and symptoms can be prevented with micronutrient supplementation after bariatric surgery, regular blood work, and discussions with your healthcare provider. 

 

**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.