Background: Nutritional deficiencies are common following Roux-en-Y Gastric Bypass (RYGB). Aetiology
is diverse; including non-compliance, altered diet, unresolved preoperative deficiency and differential degrees of
post-operative malabsorption occurring as function of length of bypassed intestine. Iron and calcium/vitamin D deficiency
occur in up to 50% of patients following RYGB. Currently, treatment strategies recommend the prescription
of oral supplements for those who become deficient. Meanwhile, debate exists regarding the absorption capacity of
these post-operatively and their efficacy in treating deficiency.
Objective: To examine the disposition of oral iron and calcium/vitamin D supplementation following RYGB.
Method: A literature review was carried out using PubMed and Embase. Data from the key interventional studies
investigating iron and calcium/vitamin D oral supplement absorption and efficacy following RYGB was summarized.
Results: Absorption of both iron and vitamin D/calcium is adversely affected following RYGB. Distribution and
metabolism may be altered by the predominance of paracellular absorption pathways which promote unregulated
influx into the circulatory system. Overall, studies indicate that current supplementation strategies are efficacious to a
degree in treating deficiency following RYGB, generally restoration of optimal status is not achieved.
Conclusion: Oral supplement disposition is altered following RYGB. As a result, patients are required to take regimens
of oral supplementation indefinitely. The dosage which confers optimum health benefit while avoiding potential
toxicity and tolerability issues remains unknown. Novel preparations with improved disposition could help limit
the extent of post-RYGB nutritional deficiencies.