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Overview.
Bari-Tec products are designed specifically for the gastric-bypass patient!
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Supplementation For the Gastric Bypass Procedure
The single most important factor in vitamin and mineral supplementation is bioavailability: the amount of nutrient that becomes available for utilization in the human body.
Simply put, if the nutrient can't pass through the intestine into the blood, it can't work its magic!
Bioavailability is even more important for patients who have undergone the Roux-en-Y gastric bypass. In this operation, the stomach and upper portion of the small intestine, the duodenum, and a considerable length of the mid-portion, the jejunem, have been bypassed.
In the remaining portion of the small intestine, the secretion of digestive juices and the number of absorption sites are reduced. Here, nutrients must find other pathways and carriers for absorption to take place.
The benefit of this anatomical rearrangement, or as patients say, "my new plumbing," is that patients can't absorb as many calories as they absorbed before the operation, thereby creating the opportunity for significant long-term weight loss.
However, for every intended "good," there is a dark side. If most calories can't get in from food, neither can many nutrients.
Tennis, Anyone? Or Ping-Pong?
If all the absorption components in the entire small intestine (the folds of Kerckring, the villi, and the microvilli), were spread out on a football field, the absorption capacity would equal about the surface area of a tennis court.
The greatest number of absorption sites is in the duodenum and to a lesser extent, the upper portion of the jejunum.
The absorption sites are greatly reduced in the lower portion of the jejunum and become even less, moving down to the end of the ileum, the ileocecal valve.
In the Roux-en-Y gastric bypass patient, the former absorption capacity of a tennis court is now the size of a ping-pong table.
The rules of the digestive absorption game have been inexorably changed forever!
With a reduction in absorption sites, an interruption in the sequence of enzyme secretion (digestive juices) and an intestinal environment that is essentially acid-free, micronutrient absorption, from dietary sources alone, is not adequate for most gastric bypass patients.
Therefore, vitamin and mineral supplementation is a daily requirement for life.
The fact that Roux-en-Y gastric bypass patients must take nutritional supplements for life is not debatable. Which supplements they are to take has become a hotly contested question among healthcare professionals.
In our analysis of more than fifty over-the-counter vitamin and mineral formulae, three criteria had to be met in order for us to recommend products to gastric bypass patients:
Example, vitamin E must be in d-alpha tocopheryl (natural) form and not dl-alpha tocopheryl (synthetic). Dl-alpha tocopheryl is much less active in the gastric bypass patient.
Example, in order to prevent Vitamin B-12 deficiency in postop gastric bypass patients, studies show that the dosage of at least 150 mcg (micrograms) of vitamin B-12 (methylcobalamin) is needed on a daily basis. That's 25 times more than the Recommended Daily Intake as established by the FDA. Most vitamin and mineral supplements contain only 6 mcg of vitamin B-12.
Example, iron as ferrous sulphate is used in most vitamin and mineral supplements. In order to be absorbed, it favors an acidic environment, and even so, its bioavailability is low.
Caution: An excessive amount of ferrous sulphate can cause bowel irritation and painful constipation.
Remember, in the gastric bypass patient, iron passes directly from the gastric pouch into the virtually acid-free jejunem. There, absorption is best facilitated when iron is bonded to an amino acid carrier. This mineral-carrier combination is known as a chelated mineral. Its bioavailability is high, especially in the jejunem. The best amino acid carrier for iron and most other minerals is glycine.
Leading nutritional researchers and vitamin and mineral formulators agree that minerals, as amino acid chelates, should be taken by gastric bypass patients every day for life.
Again, all nutritional supplements provided by the Bariatric Support System have met the 3 criteria for optimum bioavailability:
The right type
The right amount
The right carriers
