nutritional disorders
Metabolic and Bariatric Surgery
Follow up after Bariatric Surgery
Regular long-term follow-up after metabolic and bariatric surgery helps ensure adequate weight loss and prevent complications. After Roux-en-Y gastric bypass or sleeve gastrectomy, patients should be monitored every 4 to 12 weeks during the period of rapid weight loss (usually about the first 6 months after surgery), then every 6 to 12 months thereafter. Weight and blood pressure are checked, and eating habits are reviewed. Blood tests (usually complete blood count; electrolyte, glucose, bloodureanitrogen, creatinine,albumin, and protein levels; and liver tests) are done at regular intervals. Glycosylated Hb (HbA1c) and fasting lipid levels should be monitored if they were abnormal before surgery. Depending on the type of procedure, vitamin and mineral levels, including calcium,vitamin D, vitamin B12, folate, iron, and thiamin (vitamin B1), may need to be monitored. Because secondary hyperparathyroidism is a risk,parathyroid hormonelevels should also be monitored. Bone density should be measured after sleeve gastrectomy or Roux-en-Y gastric bypass. Clinicians should check for any changes in response to antihypertensives,insulin, oral hypoglycemics, or lipid-lowering medications during the period of rapid weight loss after surgery. Patients should also be regularly Diagnosis and To minimize risk of Hypoglycemia (due to increased 