The Neurological Complications of Nutritional Deficiency following Bariatric Surgery

Table 1

Complications and prevalence of nutritional deficits specified according to the particular type of bariatric surgical procedure.

	Adjustable gastric band	Roux-en-Y	Duodenal switch
Complications	(i) Food intolerance or noncompliance	(i) Anastomotic leak	(i) Malabsorption of fat soluble vitamins (A, D, E, and K), iron
	(ii) Band slippage which can result in vomiting leading to B1 deficiency	(ii) Stomal stenosis can lead to vomiting	(ii) Protein-energy malnutrition
	(iii) Pouch dilatation	(iii) Bowel obstruction
	(iv) Band erosion into the stomach	(iv) Micronutrient deficiencies
Vitamin A	Occurs	Occurs	Common: 50% after 1 yr, up to 70% after 4 yrs
Vitamin B1	Rare but occurs	Rare but occurs	Rare but occurs
Vitamin B12	Uncommon	Common: 12–33%	Rare but occurs
Folate	Uncommon	Uncommon	Uncommon
Iron	Uncommon	Common: 20–49%	Rare but occurs
Calcium	Uncommon	May occur: 10–25% by 2 yrs, 25–48% by 4 yrs	May occur: 10–25% by 2 yrs, 25–48% by 4 yrs
Vitamin D	Uncommon	Common: 17–52% by 2 yrs, 50–63% by 4 yrs	Common: 17–52% by 2 yrs, 50–63% by 4 yrs
Vitamin E	Uncommon	Uncommon	Uncommon
Vitamin K	Uncommon	Uncommon	Common: 50–60% after 1 year
Copper	Occurs but often unrecognized	Occurs but often unrecognized	Occurs but often unrecognized