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- Title
NUTRIENTS DEFICIENCY LEADING TO NEUROLOGICAL COMPLICATIONS IN BARIATRIC PATIENTS.
- Authors
Maria-Mirela, Chirvase; Sandica, Bucurica; Cristina, Patoni; Florentina, Ionita-Radu
- Abstract
Introduction. Bariatric surgery represents the most efficient treatment addressing obesity and its related consequences. Even if the medical benefits for patients are huge due to weight loss, and despite technical improvements in bariatric procedures, it is still associated with different types of complications. Most of the complications appear due to nutrient deficiency, as absorption is compromised after surgical anatomy modification, but also secondary to inflammatory and mechanical pathways induced by surgical procedures. The most common deficiencies reported after bariatric surgery are vitamin B deficiency (74%), hypovitaminosis D which is described in 25-70% of patients, and iron deficiency in more than 30% of patients. These deficiencies are associated with a wide spectrum of clinical manifestations. Objective. The aim of this review is to identify neurological complications that occur after bariatric surgery. Methods. We performed a systematic search in two databases, PubMed and Google Scholar, from inception until February 2023, without language restrictions. We included all observational studies that described neurologic manifestations after the bariatric procedure regardless of the surgical technique used. Results. Nutritional impairment after bariatric surgery is common and implies a large spectrum of vitamin and micronutrient deficiencies, fat malabsorption, protein loss, and mineral deficiencies with different clinical manifestations. Neurological complications after bariatric surgery are very diverse with an occurrence within days to years after surgery, most frequently in patients with gastrointestinal or surgical complications. Any segment of the nervous system can be affected with different types of manifestations ranging from peripheral axonal neuropathy, nerve palsy secondary to compartment syndrome, encephalopathy, myelopathy, to psychiatric and demyelinating central nervous system diseases. Identifying patients at risk and systematic screening for nutrients deficiency with proper supplementation is essential for preventing neurological complications and lifelong sequelae. Conclusions. Complications after bariatric surgery have a broad spectrum of manifestations involving both peripheral and central nervous system and should be suspected and diagnosed as soon as possible to prevent long term sequelae. The risk of developing central nervous system demyelination or stroke events after bariatric surgery should be further evaluated in future studies.
- Subjects
DEFICIENCY diseases; VITAMIN B deficiency; CENTRAL nervous system diseases; MORBID obesity; GASTRIC bypass; PERIPHERAL nervous system; BARIATRIC surgery; GASTRIC banding
- Publication
Journal of Gastrointestinal & Liver Diseases, 2023, Vol 32, p96
- ISSN
1841-8724
- Publication type
Article