Many patients are concerned about significant malnutrition and vitamin deficiencies after surgery, but this is very uncommon. Unlike the Duodenal Switch, patients rarely require extensive vitamin supplements after gastric bypass surgery. However, iron deficiency is very common, occurring in up to 25% of all postoperative patients. This occurs because most iron absorption occurs in the first portion of the small intestine which is bypassed after the surgery. The vast majority of patients who suffer from iron deficiency after surgery respond well to iron supplements. I treat iron deficient patients with a Bariatric iron formulation that is better absorbed in the second part of the intestine. The most common, non-bariatric iron supplement is Ferrous Sulfate. Ferrous Sulfate is poorly absorbed by most gastric bypass patients and also causes significant constipation. Bariatric formulations (also known as chelated iron) rarely cause constipation and are more effective at raising your iron levels.
While most patients respond well to oral iron supplements, a small percentage of patients require intravenous iron infusions. Most of the time, these infusions only need to be given over a month or two until the iron levels return to normal. After the infusions, patients can be maintained on oral iron supplements.
For most patients, iron deficiency after surgery is very manageable if you and your doctors stay on top of it. If you ignore your iron levels for several years, you run the risk of developing a severe deficiency that requires regular intravenous infusions and occasionally, a blood transfusion. Most of the time, this could have been prevented if the patient’s iron levels were checked regularly. All gastric bypass patients should have their iron level checked yearly, and more frequently if they are low. Daily, appropriate iron supplementation is often a part of life after gastric bypass surgery.