What potential nutritional deficiencies may occur after this surgical procedure? Why might Mrs. Rodriguez be at risk for iron-deficiency anemia, pernicious anemia, and/or megaloblastic anemia?
What will be an ideal response?
Long-term complications can include:
• Weight loss
• Iron malabsorption
• Steatorrhea
• Calcium malabsorption
• B12 deficiency
• Folic acid deficiency
Mrs. Rodriguez may be at risk for several types of anemia.
• Iron-deficiency anemia can result because iron is poorly absorbed when it is not exposed to hydrochloric acid (HCl) in the stomach.
- With this surgery, exposure to HCl is decreased due to decreased transit time and poor mixing of gastric contents.
- Additionally, most dietary iron is absorbed in the duodenum, which is bypassed as a result of this surgery.
• Pernicious anemia may occur secondary to B12 deficiency.
- B12 absorption requires adequate amounts of intrinsic factor, which is produced in the stomach.
- Surgery may decrease the amount of intrinsic factor available for absorption.
• Folate deficiency may be a result of poor intake and/or iron deficiency and may result in megaloblastic anemia.
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