University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


General Surgery


Dr. Elyse J. Watkins



Purpose: The purpose of this article is to review the diagnosis and treatment of iron deficiency anemia in bariatric post-surgical patients who have had Roux-en-Y gastric bypass or sleeve gastrectomy.

Method: A literature search was conducted using the databases for PubMed and the Cochran Library with search terms iron deficiency in bariatric patients, anemia, oral iron replacement, and IV iron infusion. Twenty-three pertinent articles were retrieved, and they serve as the basis for this clinical review.

Results: Standard oral iron replacement is not sufficient in replenishing iron stores in a reasonable time period.1 Bariatric specific specialty multivitamins and iron are more efficient that standard oral iron formulations in maintaining iron levels,2 but not as effective as intravenous iron for replacing deficiencies. Intravenous iron replacement is safe, effective, and replaces iron stores in days to weeks. More research is needed on bariatric specific oral iron replacement.

Conclusion: Oral iron is the most commonly used form of treatment for iron deficiency anemia. Side effects such as gastrointestinal upset, constipation, and nausea coupled with the multiple daily dosing schedules contribute to patients stop taking the required doses. Newer bariatric specialty multivitamins and iron have increased compliance, and may be effective in maintaining iron stores, but are inefficient for iron replacement in deficient states. For bariatric patients with iron deficiency the treatment of choice is intravenous iron replacement.3


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