BARIATRIC SURGERY LINKED WITH PERIPHERAL NEUROPATHY

BARIATRIC SURGERY LINKED WITH PERIPHERAL NEUROPATHY
Posted by Dr. John

OBESITY RISE SPURS ON BARIATRIC SURGERY

With 36.5% of U.S. adults suffering from obesity (according to latest statistics by the CDC National Center for Health), we are seeing an ever increasing rise in bariatric surgery.  Approximately 179,000 to 190,000 bariatric surgeries are performed every year.

 

Bariatric surgery (weight loss surgery), includes a variety of procedures that achieve weight loss by surgically reducing the size of the stomach, by removing a significant portion of the stomach,  or by resecting and rerouting the small intestine to a very small stomach pouch. 

Bariatric surgery works in one of three ways:

  • Restriction, or limiting the amount of food intake by reducing the size of the stomach
  • Limiting the absorption of foods in the intestinal tract by “bypassing” a portion of the small intestine to varying degrees (also known as malabsorption)
  • Combination of both restriction and malabsorption

 

Currently, in the U.S., five types of bariatric surgical procedures are generally used to obtain continued weight loss. Gastric banding or gastric stapling are considered restrictive bariatric surgeries, meaning they only restrict food intake.  They don’t interfere with the normal digestive process. . BPD-DS is mainly a malabsorptive bariatric surgery.   In this procedure a part of the lower stomach is removed. The remaining portion of the stomach is connected to the lowest part of the small intestine. As food is digested, it completely bypasses the upper three-foruths of the small intestine. This surgery results in a greater degree of nutritional deficiencies. Gastric bypass surgery is a combination of both restriction and malabsorption.

 

NEUROLOGICAL COMPLICATIONS COMMON

Although bariatric surgery is very successful at allowing a person to decrease their body fat by up to 50%, physicians should be aware that neurological complications are very common following bariatric surgery, as cited in a new Mayo Clinic study.

 

The recent Mayo clinic study stated that rapid weight loss, postoperative complications, prolonged gastrointestinal (GI) problems, and poor nutritional support place morbidly obese patients undergoing gastric bypass surgery at heightened risk of developing neurological ailments, primarily peripheral neuropathy.

One of the most important factors linked with the development of peripheral neuropathy following surgery was the rapid weight loss. 

 

Conclusions resulted from a study of 356 morbidly obese adults, who underwent gastric bypass surgery from 1985 – 2001.  Almost 18% of the surgical cases developed symptomatic peripheral neuropathy.  The Mayo clinic reports this as being significantly high.

 

The neurological disorders ranged from both sensory and motor peripheral neuropathy.  Sensory patients developed the typical ‘Stocking and Glove’ distribution of symptoms along with a loss of coordination.  Motor neuropathy resulted in extreme muscle weakness in the arms or legs.

 

The study also revealed that one third of the patients that developed peripheral neuropathy also suffered from prolonged vomiting and/or diarrhea.  A common complication of bariatric surgery.

 

“We as physicians must bear in mind the risk of neurological complications following bariatric surgery, which is increasingly performed in the U.S. and other countries,” stated by Joseph R. Berger, MD, Professor and Chair of the Department of Neurology at the University of Kentucky in Lexington.

 

Dr. Berger further stated, “While bariatric surgery can result in weightloss of 50% of body weight, the complications exceed those of all other abdominal surgery.  The mortality rate is 0.4% due to pulmonary embolisms.  The complication rate is 10%, commonly requiring additional surgery due to bleeding, abscesses, and wound complications.  Delayed complications are frequently seen as a result of nutritional deficiencies.  Dr. Berger said, “Iron, calcium, and potassium are often depleted and 10% – 12% of bariatric patients will develop vitamin B-12 deficiencies, and up to 6% more will develop fat soluble vitamin deficiencies (vitamin D, vitamin E, vitamin A, vitamin K) – each atributing to peripheral neuropathy and other neurological complications.

 

 

Sourced through Scoop.it from: www.ncbi.nlm.nih.gov

Bariatric Surgery… No ‘Magic Solution

Both the Mayo Clinic and the CDC predict that more cases of bariatric surgery-associated neuropathies will continue to rise due to the ‘sky-rocketing’ rise in obesity around the world.  From 1990 to 1997, the number of bariatric surgeries performed in the U.S. more than doubled. 

 

The most current figures by the CDC report that 33% of American adults are morbidly obese, 60% of U.S. adults are overweight and 25% of children are overweight and numbers continue to rise rapidly.  As a result, more and more adults are looking to bariatric surgery as their answer for weight loss and who could blame them when you hear statistics touting that 90% of patients lose 50% of their weight.  It certainly sounds like a promising and far easier way to weight loss, but there is an alarming fact that is not commonly disclosed.

 

In recent years, published research has demonstrated that sustained weight loss is typically very difficult for most bariatric patients – including those who experienced initial success.  Most patients reach their maximum weight loss 1-3 years following surgery, but research shows that, on average, patients will regain 30% of their weight-loss after 10 years.  Even more alarming is that 25% of all bariatric surgery patients will regain all of their lost weight back by 10 years and 20% of bariatric patients fail to lose significant  weight, at all, according to the International Journal of Obesity and Metabolic disorders.

 

Numerous other studies reported by the Journal of Diabetes Care, have shown the following complications that arise as a result of bariatric surgery:

  • CHRONIC VOMITING* (during the first few months)
  • CHRONIC DIARRHEA* (resulting in dehydration and mineral loss)
  • DEHYDRATION*
  • HAIR LOSS
  • B-12 DEFICIENCY*
  • B-6 DEFICIENCY*
  • B-1 DEFICIENCY*
  • IRON DEFICIENCY
  • COPPER DEFICIENCY*
  • CALCIUM DEFICIENCY*
  • POTASSIUM DEFICIENCY
  • OSTEOPOROSIS
  • VITAMIN A DEFICIENCY
  • VITAMIN D DEFICIENCY*
  • VITAMIN E DEFICIENCY*
  • VITAMIN K DEFICIENCY

 

The asteriscs above denote all of the deficiency factors that contribute to and directly cause peripheral neuropathy.  Unfortunately as the bariatric surgery rates continue to rise, so will the rates of peripheral neuropathy cases, as reported by the American Academy of Neurology.

 

There are much safer alternatives to shedding the weight.  Remember, there is NEVER any MAGICAL PILL, POTION or LOTION.

 

If you have undergone bariatric surgery and now suffer from peripheral neuropathy, there is hope for you.  You don’t have to live with your neuropathy.  To learn more about what you can do to reverse your neuropathy – visit: http://www.nervedoctor.info/ or contact us at:  http://nervedoctor.info/contact/