disorders of nutrition
Metabolic and Bariatric Surgery
Evaluation for Metabolic and Bariatric Surgery
Before metabolic and bariatric surgery, people are evaluated to determine whether surgery is likely to help them. Doctors try to determine how ready and able people are to follow the lifestyle changes required after the surgery. A physical examination and tests are done. Tests may include the following: Tests that are routinely done before surgery to check how well vital organs are functioning Blood tests, including liver tests (to determine how well the liver is functioning and whether it is damaged) and measurement of blood sugar levels and cholesterol and other fat (lipid) levels (after fasting) Blood tests to measurevitamin D, vitamin B12, folate, and iron levels Electrocardiography to check for coronary artery disease Sometimes evaluation of the digestive tract (with x-rays or endoscopy) Sometimes Ultrasonography of the abdomen, including the gallbladder Sometimes Echocardiography and Other Ultrasound Procedures (ultrasonography of the heart) Sometimes Pulmonary Function Testing (PFT) to evaluate how well the lungs are functioning—for example, if people have asthma or chronic obstructive pulmonary disease (COPD) Sometimes Thyroid function tests None Sometimes Diagnosis (including polysomnography) and testing for sleep apnea When certain disorders are detected, measures are taken to control them and thus reduce the risk of surgery. For example, high blood pressure is treated. People who smoke are advised to stop at least 8 weeks before surgery and preferably permanently. Smoking increases the risk of respiratory problems and the risk of ulcers and bleeding in the digestive tract after surgery. Mental health and nutritional evaluations are also done. People should tell their doctor about any medications or medicinal herbs they are taking. Some medications, including anticoagulants (such aswarfarin) andaspirin, may be stopped before surgery. 