After gastric bypass surgery, the patient is getting vitamin B12 via injection. The patient asks why he can't get the vitamin by mouth. The nurse explains that:
a. the patient may not have enough intrinsic factor for normal absorption.
b. the patient would have to drink water, and the small intestine can't handle water.
c. the vitamin is absorbed in the upper part of the small bowel and would travel too fast.
d. all vitamins are absorbed in the terminal ileum and it would take too long for B12.
A
Vitamin B12 is absorbed in the terminal ileum in the presence of intrinsic factor produced in the stomach. Gastric bypass may lead to reduced levels of intrinsic factor. The small intestine also handles water, electrolyte, and vitamin absorption. Vitamins, with the exception of B12, and iron are absorbed in the upper part of the small bowel.
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