Anemia following surgery for morbid obesity

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Morbid obesity is one of the most common causes of morbidity and mortality in Western countries. Roux-en-Y gastric bypass (RYGB) has become a common procedure for achieving short- and long-term weight loss. It has gained great popularity among surgeons and patients in recent years. Long-term complications are still being discovered. Because of the altered anatomy, absorption of iron from the proximal gastrointestinal tract is impaired. Anemia develops in some patients with inadequate oral supplementation or chronic occult blood loss.

A research article to be published on April 21, 2010 in the World Journal of Gastroenterology addresses this question. A research team led by Dr. I Michael Leitman evaluated the incidence and risk factors for the development of anemia after Roux-en-Y gastric bypass (RYGB).

They found twenty-one of 206 (10.2%) patients developed anemia at some point during the post-operative period. Following statistical analysis, patients with the greatest risk for anemia were menstruating females and patients found to have marginal ulcer on endoscopy. In all cases anemia was due to iron deficiency (low serum ferritin, elevated total iron binding capacity, and low mean corpuscular volume).

This study concluded that increased ferrous sulfate supplementation may be necessary to prevent iron depletion in populations at increased risk of developing iron deficiency anemia after RYGB surgery, such as menstruating women and patients with peptic ulcer disease.

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Reference
Avgerinos DV, Llaguna OH, Seigerman M, Lefkowitz AJ, Leitman IM. Incidence and risk factors for the development of anemia following gastric bypass surgery. World J Gastroenterol 2010; 16(15): 1867-1870

Correspondence to
I Michael Leitman, MD, Department of Surgery, Beth Israel Medical Center, Albert Einstein College of Medicine, 10 Union Square East, Suite 2M, New York, NY 10003, United States.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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