Calcium and Vitamin D Deficiencies in Bariatric Surgery

Parimala Devi and Praveen Raj Palanivelu


Nutritional deficiencies are common after all kinds of bariatric procedures and can be due to both macronutrient and micronutrient deficiencies [1-4]. This can be attributed to vomiting, decreased food intake, food intolerance, reduction of gastric secretions, bypass of absorption surface areas and altered drug bioavailability that occur after bariatric procedures [5, 6]. Bypass of absorption surface areas is perhaps the most important factor in the cause of nutritional deficiencies and the risk of developing these deficiencies seems to be proportional to the length of bypassed proximal intestine [7].

One micronutrient of importance in the morbidly obese when considering bariatric surgery is calcium [8]. Understanding calcium metabolism in these patients is important because some bariatric procedures can lead to vitamin D malabsorption, hypocalcaemia and hyperparathyroidism.

This chapter aims to understand the alterations in calcium and vitamin D metabolism after different types of bariatric procedures and the appropriate supplementation required to maintain a proper calcium homeostasis.

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