| Surgery type | Affect on absorbtion | Annual blood test | Routine supplementatin |
| Gastric band |
No impact on absorption Over tight gastric band affects nutritional quality of diet including protein and iron |
If there is any suspicion that the patient is not adhering to a nutritionally balanced diet, appropriate blood tests should be done | |
| Sleeve gastrectomy | May be some impact on absorption including iron and vitamin B12 |
LFT, FBC, Ferritin, Folate, Calcium, Vitamin D &PTH Vitamin B12 -If patient is having three monthly intramuscular injections of vitamin B12, there may be no need for annual checks Zinc, Copper & Selenium -Measure when concerns for example, if screening for iron deficiency anaemia is negative, hair loss, pica, neutropaenia or for example, cardiomyopathy, chronic diarrhoea |
Multivitamin and mineral incl Folic acid & Zinc, Copper & Selenium (Sanatogen A-Z contains all these) Iron Calcium and vitamin D B12 - variation between centres as to whether routine supplementation |
| Gastric bypass |
Impacts on absorption of iron, vitamin B12, calcium and vitamin D Long limb bypasses may affect absorption of protein, fat, vitamin A and trace elements in addition |
LFT, FBC, Ferritin, Folate, Calcium, Vitamin D &PTH Vitamin B12 -If patient is having three monthly intramuscular injections of vitamin B12, there may be no need for annual checks Zinc, Copper & Selenium - Measure when concerns for example, if screening for iron deficiency anaemia is negative, hair loss, pica, neutropaenia or for example, cardiomyopathy, chronic diarrhoea Vitamin A - If the patient has a long limbed bypass, symptoms of steatorrhoea or night blindness |
Multivitamin and mineral incl Folic acid & Zinc, Copper & Selenium (Sanatogen A-Z contains all these) Iron Calcium and vitamin D B12 - variation between centres as to whether routine supplementation |
| Duodenal switch | Impacts on absorption of protein, fat, calcium, fat soluble vitamins A, D, E and K, zinc |
LFT, FBC, Ferritin, Folate, Calcium, Vitamin D &PTH
Vitamin B12 - If patient is having three monthly intramuscular injections of vitamin B12, there may be no need for annual checks Zinc, Copper & Selenium - Measure when concerns for example, if screening for iron deficiency anaemia is negative, hair loss, pica, neutropaenia or for example, cardiomyopathy, chronic diarrhoea |
Multivitamin and mineral incl Folic acid & Zinc, Copper & Selenium (Sanatogen A-Z contains all these) Iron Calcium and vitamin D |
https://www.bomss.org.uk/wp-content/uploads/2014/09/GP_Guidance-Final-version-1Oct141.pdf
Patient leaflet
Vitamins and Minerals leaflet for patients who have had bariatric surgery
