When is iron deficiency anemia a complication of surgery?

Updated: Aug 04, 2019
  • Author: James L Harper, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Extensive surgical removal of the proximal small bowel or chronic diseases (eg, untreated sprue or celiac syndrome) can diminish iron absorption. In patients who have undergone bariatric surgery, postoperative gastric hypochlorhydria impairs iron absorption; in those who have undergone Roux-en-Y gastric bypass surgery, bypass of the duodenum impairs reduction of iron to the ferrous (absorbable) state. In addition, patients tend to eat less food after bariatric surgery, often less meat, which leads to decreased intake of heme iron. [5]

Rarely, patients with no history of malabsorption have iron deficiency anemia and fail to respond to oral iron therapy. Most merely are noncompliant with therapy.


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