Our Summary

This research paper discusses the increase in bariatric surgeries (procedures used to help people lose weight) due to the rise in obesity, as well as for cosmetic reasons. The paper highlights that these surgeries often result in nutritional deficiencies, which can lead to serious and lasting nerve damage.

Two cases are presented where patients developed severe nerve damage after a specific type of bariatric surgery called a sleeve gastrectomy. Despite considering severe thiamine (a type of vitamin B) deficiency as a potential cause, proving this was delayed and it was difficult to rule out other possible causes.

The authors stress the need for neurologists to be aware that thiamine deficiency can affect both the central and peripheral nervous system, to prevent permanent disability. They also propose that clear information about the risk and signs of thiamine deficiency should be routinely given to patients after they have had this type of surgery.

FAQs

  1. What is the link between gastrectomy and nutritional deficiencies?
  2. What are the potential neurological consequences of gastrectomy?
  3. Why is it important for neurologists to be aware of the signs of thiamine deficiency in patients who have undergone gastrectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is to ensure they are closely monitoring their nutritional intake and following any dietary guidelines provided by their healthcare team. This is especially important to prevent potential deficiencies, such as thiamine deficiency, which can lead to severe neurological complications. Patients should also be vigilant for any signs of deficiency, such as weakness, numbness, or tingling in the extremities, and seek medical attention if they experience any concerning symptoms. It is important for patients to communicate any changes in their health or symptoms to their healthcare provider to ensure prompt diagnosis and treatment.

Suitable For

Patients who are typically recommended gastrectomy are those with severe obesity that has not been successfully treated with other methods, such as diet and exercise, or those with certain types of stomach cancer or other medical conditions that require removal of part or all of the stomach. Additionally, some patients with severe gastroesophageal reflux disease (GERD) or other digestive disorders may also be recommended for gastrectomy.

Timeline

Before gastrectomy:

  • Patient consults with a healthcare provider about weight loss options
  • Patient undergoes various tests and evaluations to determine if they are a candidate for gastrectomy
  • Patient discusses risks and benefits of surgery with healthcare provider
  • Patient prepares for surgery by following pre-operative instructions

After gastrectomy:

  • Patient undergoes surgery and stays in hospital for recovery
  • Patient may experience pain and discomfort post-surgery
  • Patient is monitored for complications and given instructions for post-operative care
  • Patient begins a liquid diet and gradually transitions to solid foods
  • Patient may experience weight loss and improved health outcomes
  • Patient is at risk for nutritional deficiencies, including thiamine deficiency
  • Patient may develop neurological symptoms if thiamine deficiency is not addressed promptly
  • Patient may require long-term supplementation and monitoring for nutritional deficiencies

What to Ask Your Doctor

  1. What specific nutritional deficiencies should I be aware of following gastrectomy?
  2. How often should I have blood tests to monitor my nutritional levels?
  3. Are there any dietary supplements or special diet recommendations I should follow?
  4. What signs or symptoms should I watch out for that could indicate a deficiency?
  5. How can I prevent or manage potential neurological complications related to nutritional deficiencies?
  6. Are there any lifestyle changes I should make to support my overall health after gastrectomy?
  7. Are there any support groups or resources available to help me navigate the nutritional challenges of gastrectomy?

Reference

Authors: Liem B, Tai XY, Begeti F, Fathima FF, Hofer M, Matthews L, Rinaldi S, Bennett DLH, Turner MR. Journal: Pract Neurol. 2025 May 15;25(3):268-272. doi: 10.1136/pn-2024-004219. PMID: 39059794