Medical Terms

Anemia
Iron deficiency can be a problem following Gastric Bypass because iron is partially absorbed in the duodenum. The duodenum is bypassed along with the stomach. Iron deficiency can be a particular problem for women who lose blood (and thus iron) with menstruation.

We recommend that all gastric bypass patients eat foods that are high in iron, and that iron and hemoglobin levels are checked once or twice a year. For menstruating women we suggest a daily iron supplement such as Ferrous Sulfate or Ferrous Gluconate 300 to 350mg per day. 

Iron absorption seems to be enhanced by adequate Vitamin C intake. We suggest that all patients take a full potency multivitamin daily. Most multivitamins contain about 60mg Vitamin C. This should be adequate under normal conditions. When one is iron deficient and trying to replace iron stores, increasing Vitamin C intake to 500mg per day may be helpful. 

B12 Deficiency
It is a water-soluble hematopoietic (necessary for manufacture of red blood cells) vitamin occurring in meats and animal products. To be absorbed by the intestine, B12 must combine with intrinsic factor, and its metabolism is interconnected with that of folic acid. The vitamin is necessary for the growth and replication of all body cells and the functioning of the nervous system. Deficiency of vitamin B12 causes pernicious anemia and other forms of megaloblastic anemia, and neurologic lesions. 

Vitamin B12 is stored in the liver. A healthy adult has a large reserve supply of B12 available, and B12 levels tend to change slowly. 

We recommend that our patients take sublingual (under the tongue) B12, 1000 micrograms per week. B12 supplements that are swallowed don't get absorbed well. Sublingual preparations are in a crystalline form and can be absorbed directly into the blood stream through the tissues under the tongue. 

Your B12 level can be checked with a blood test. We recommend that your level be tested every six months so that you can be sure that you have enough of this important vitamin. 

Osteoporosis
Osteoporosis is a progressive disease that causes bones to become thin and brittle, making them more likely to break. Both women and men are more apt to have osteoporosis if they fail to reach their optimum bone mineral density during the childhood and teenage years, critical times for building bones. 
Osteoporosis is related to the loss of bone mass that occurs as part of the natural process of aging. Although osteoporosis can occur in men, it is most common in women who have gone through menopause.
Not getting adequate calcium and phosphorus—two minerals needed for bone density and strength—and a lack of vitamin D can also contribute to the development of osteoporosis. 
Treatment for osteoporosis includes eating a diet with sufficient calcium and vitamin D, getting regular exercise, and taking medication to reduce bone loss and increase bone thickness. 

Dumping syndrome
Dumping syndrome occurs after gastric bypass when food passes too quickly into the small intestine and is particularly induced when you eat sweet foods. (e.g. simple carbohydrates like sugar and some starches). 
Symptoms include: nausea or queasiness, a sense of fullness accompanied by discomfort, cramping, diarrhea, general weakness, profuse sweating, vomiting, and heart palpitations (an increase in heart rate). 
Usually the symptoms will subside in about an hour. Most patients find the symptoms are alleviated after they lie down for a while. Dumping syndrome is not dangerous, but as you can tell by the symptoms, it's quite unpleasant. 

Peritonitis
Peritonitis is an infection of the lining of the abdominal wall (peritoneum) caused by bacteria or irritating substances. Peritonitis causes pain and swelling in the abdomen and can be very serious if not treated.
Symptoms of peritonitis include:
· Swelling of the abdomen, which may feel hard (rigid). 
· Severe pain and tenderness in the abdomen that becomes worse with moving, coughing, or pressing on the abdomen. The pain sometimes reaches into the shoulder. 
· Nausea and vomiting. 
· A rapid pulse. 
· Chills and fever. 
· Rapid breathing.
A person with these symptoms requires immediate medical attention. Treatment typically involves surgery and antibiotics. Without treatment, the illness gets worse rapidly and can become life-threatening.

Pulmonary embolism
Pulmonary embolism is sudden blockage of blood flow in an artery in the lung. The blockage (an embolus) can be caused by a blood clot, tumor, amniotic fluid, or fat in the artery. 
Blood clots in the deep veins of the leg are the most common cause of pulmonary embolism. A clot may break loose from a deep vein in the leg and travel to a pulmonary artery in the lung, where it can block blood flow. Pulmonary embolism can be a very serious condition that can result in death. Symptoms of a pulmonary embolus include:
· Sudden, sharp chest pain. 
· Shortness of breath. 
· Chest pain that worsens with deep breathing or coughing. 
· Coughing up blood. 
· Rapid heart rate. 
· Sweating. 
· Anxiety.
Pulmonary embolism is treated in the hospital with monitoring, oxygen, and anticoagulants to prevent more blood clots.

Ulcers
An ulcer is a sore that develops on the skin or a mucous membrane (such as inside the mouth, stomach, or intestines). Ulcers can be shallow or deep and can destroy the skin or the membrane where they develop.
Ulcers can be caused by some types of infection, injury, or cancer.

Hernia
A hernia is tissue from inside the abdomen that bulges out through a weak spot in the muscles of the abdominal wall. The weak spot may have been present since birth or may develop following surgery, violent or chronic coughing, lifting heavy objects, or from aging.