Osteoporosis
Bone Disease
from Gastric Bypass
1.
Recommended Calcium intake daily 1200 – 1500 mg (or per physician
instructions)
2.
If you are post Gastric Bypass Surgery 6 – 12 months and are not
taking a calcium supplement, you should have a Parathyroid hormone test (PTH)
done. (need order from physician)
3.
Bone density studies will not show calcium deficiencies.
4.
Exercise
5.
Women are more susceptible, due to hormone loss. But, it does not
exclude men who have had bariatric surgery.
Prevention
Osteoporosis is largely preventable for most people
however; osteoporosis following gastric bypass can be expected at an earlier
age than postmenopausal osteoporosis. Men with bypass operations are also at
risk. Therefore, patients need life-long follow-up
There are four steps to prevent osteoporosis. No one
step alone is enough to prevent osteoporosis but all four may. They are:
1.
A balanced diet rich in calcium and vitamin D
2.
Weight-bearing exercise
3.
A healthy lifestyle with NO Smoking or Excessive alcohol
use.
4.
Annual follow-up with possible PTH when appropriate.
Calcium
Calcium is needed for the heart, muscles and nerves to
function properly and for blood to clot. Inadequate calcium is thought to
contribute to the development of osteoporosis.
Calcium is a mineral found in many foods and adequate
calcium intake is important because the human body cannot produce calcium.
One way to increase the amount of calcium in your diet is
to eat calcium-rich foods like low-fat milk, broccoli and foods that are
fortified with calcium such as cereals, orange juice and breakfast bars.
Vitamin D
Vitamin D is needed for the body to absorb calcium.
Without enough vitamin D you will be unable to absorb calcium from the foods
you eat, and your body will have to take calcium from your bones. Experts
recommend a daily intake between 400 and 800 international units (IU) do not
take more than 800 IU per day unless your doctor prescribes it.
Vitamin D plays a major role in calcium absorption. It
can be described as the key that unlocks the door and allows calcium to leave
the intestine and enter the bloodstream.
The major food sources of vitamin D are vitamin
D-fortified dairy products, egg yolks, saltwater fish and liver. Some calcium
supplements and most multivitamin contain vitamin e, so it is important to
check the labels to determine how much each contains.
Exercise
Just as a muscle gets stronger and bigger the more you
use it, a bone becomes stronger and denser when you place demands on it.
If your bones are not called upon to work, such as during
physical activity, they do not receive any messages that they need to be
strong. Thus, a lack of exercise particularly because your are gastric bypass
patients may contribute to lower bone mass or density.
You cannot see your bones respond to exercise, but when
you strike a tennis ball or land on your feet after jumping, chemical
messengers tell your arm and leg bones to be ready to handle the weight and
impact.
Two types of exercise are important for building and
maintaining bone mass and density: weight-bearing and resistance exercises.
Weight-bearing exercises are those in which your bones and muscles work
against gravity. This is any exercise in which your feet and legs are bearing
your weight. Jogging, walking, stair climbing, and dancing are examples of
weight-bearing exercise with different degrees of impact. Swimming and
bicycling are not weight bearing.
The second type of exercise is resistance exercises or
activities that use muscular strength to improve muscle mass and strengthen
bone. These activities include weight lifting, such as using free weights and
weight machines found at gyms and health clubs.
Most weight bearing and resistance exercise place health
demands on bone. Daily activities and most sports involve a combination of
these two types of exercise. Thus, an active lifestyle filled with varied
physical activities strengthens muscles and improves bone strength.
This brings us back to the need for lifetime follow-up.
The patient is the only one who can, with certainty, be around for a lifetime
to guide such care. That means that informed consent is an essential part of
long-term care. Informed consent should be an ongoing educational process.
It should be based upon accumulating knowledge. The more we study potential
problems of our patients, the more information we can provide before and after
the operation. Modern date management makes lifetime study and education of
patients realistic. We need much more information about the frequency,
severity and response to treatment of metabolic bone disease following the
many forms of bypass that are in use for controlling obesity. To avoid
surprises such as irreversible skeletal changes, patients need life-long
follow-up.
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