Abstract
ABSTRACTIntroduction: Bariatric surgery is considered the most effective tool in the control and treatment of severe obesity, but patients undergoing this procedure are at increased risk of developing nutritional deficiencies by limiting the intake and absorption of many nutrients.Objective: To assess the impact of vitamin D deficiency and calcium in bone in patients after gastric bypass in Roux-en-Y, pointing directly at the type of administration, doses and effects after surgery.Method: Was conducted a systematic review with articles related to the topic of the last 10 years searched in PubMed (US National Library of Medicine National Institutes of Health, Medline, Lilacs, Scielo and Cochrane using the headings "bariatric surgery", "bone", "obesity", "vitamin D '', "calcium" AND "absorption". Exclusion criteria to research on animals, smokers, pregnant women and patient treated with bisphosphonates.Results: Five articles were included in this review. All refer that bariatric surgery can lead to nutritional deficiencies and poor absorption of fats and fat-soluble vitamins and other micronutrients such as calcium.Conclusion: Patients submitted to RYGB should make use of multivitamins and minerals especially vitamin D and calcium to prevent bone fractures. Monitoring, treatment and control of risk factors are essential to prevent complications after this operation.
Highlights
S ince the development of bariatric surgery, many surgical methods for the treatment of morbid obesity have been developed over the past decades
The malabsorption procedures have been recognized as a risk factor for the development of bone[5,8,12,17,28] disease as a result of modification of calcium (Ca) metabolism and impairment of its absorption . 4,7,14,16,18,22,23 Only a few studies have investigated the absorption of Ca prospectively in patients with jejunoileal bypass and showed that absorption decreases by 50% after surgery[7,14,22]
Inadequate intake Ca is common after gastric bypass[1,20], which can contribute to altered bone loss[6]
Summary
S ince the development of bariatric surgery, many surgical methods for the treatment of morbid obesity have been developed over the past decades. The Roux-Y gastric bypass (RYGB) is an operation which is considered gold standard treatment alternative for severe obesity[3] because it promotes less severe absorption and complications than traditional malabsorption procedures, such as jejunoileal bypass[3,15,26]. 4,7,14,16,18,22,23 Only a few studies have investigated the absorption of Ca prospectively in patients with jejunoileal bypass and showed that absorption decreases by 50% after surgery[7,14,22]. Understand the postoperative RYGB decrease in absorption and calcium intake and investigate the doses, routes of administration, the time of drug therapy and its effects on bone, were the objectives of this review
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