In studies with alcohol use in volume-reducing surgeries such as gastric band and sleeve gastrectomy, no difference was found for the alcohol content in the inhaled air in the evaluations made before the operation, at the 3rd and 6th months. In addition, when we compare the preoperative period with the 3rd and 6th months in patients who underwent bypass, 2-3 times more alcohol was detected in the respiratory air despite the same dose of alcohol being consumed.
Does vitamin B12 absorption change after bariatric surgery?
The stomach plays a critical role in vitamin B12. A protective protein secreted from the stomach binds to vitamin B12 and prevents the vitamin from being broken down by pancreatic enzymes. The last part of the intestine is the normal absorption site of vitamin B12. After tube-stomach and by-pass surgery, this protective bond does not occur and there is a vitamin deficiency. This situation is observed more severely in by-pass surgeries as absorption is impaired. In general, since the body stores will be empty after 1 year, vitamin deficiency is not observed in the early period.
• To avoid dehydration, consume more water, prefer low-calorie or no-calorie liquids. All liquids should be caffeine-free.
• Sip sips of liquid should be taken between meals.
• At least 2 liters of fluid should be taken per day. Although not in the first period, the target will be met later.
• We have to insist that the use of alcohol is prohibited. It can make you lose control.
• You can protect your muscle tissue by eating a protein-rich diet. Eggs, meat, fish, soy milk, cheese, yogurt and other dairy products contain high protein. Your goal should be to get 65-75 grams of protein per day. Do not be alarmed if you think that you will not be able to reach these goals in the first few months.
• By-pass patients need regular vitamin supplements, they may not be needed in gastric reduction surgeries.
Although the new eating habit may overwhelm you at first, most patients get used to this type of nutrition in the future.
General rules;
• Eat meals in small portions
• Eat foods that are low in calories, fat and sugar.
• Record your daily food portion, calorie and protein amount
• Take small amounts into your mouth by chewing slowly and thoroughly.
• Do not choose rice, bread, pasta, raw vegetables and meats that you do not chew well. Meatballs are better tolerated.
• Do not use legumes, carbonated drinks and ice, as these will cause a feeling of discomfort by causing gas.
• Avoid sugar, fruit juices containing sugar and sweets.
• Limit your calorie intake to 300-600 calories per day in the first two months after the surgery.
• Your daily calorie intake should not exceed 1000 calories.

Copper is an essential element for the body to use energy and has a critical role in iron absorption. Copper is absorbed from the first part of the small intestine. An average of 1-2 g of copper is needed per day and the excess is excreted with bile. Serious copper deficiencies will be seen in bariatric surgeries where the first part of the intestine is by-passed. Copper competes with zinc for absorption from the small intestine. We must not forget that excess zinc will directly result in copper deficiency.
Zinc is an essential element that has an effect on DNA regulation, growth, brain development and wound healing. The main determinant mechanism of body zinc level, unlike others, is not the intake from food, but the regulation of its excretion with urine and feces. Based on this information, dumping syndrome and diarrheal conditions beyond absorption in patients undergoing by-pass will further accentuate zinc deficiency.

Indeed, no definition has been made with the amount of carbohydrates to be taken after bariatric surgery and there is no study on this subject. But the most important finding we have is that 50 grams of carbohydrates should be taken daily to ensure normal brain activity, which is mentioned in the data of the world health organization. One should be very careful while arranging the diet after the surgery. Patients should prefer more complex sugars such as fruits and vegetables instead of processed sugars. When the need for calories increases due to use, it seems more appropriate to meet it from protein, vegetables and fruits. People who have undergone bariatric surgery must take 3 main meals and 2 snacks instead of meals when they are hungry. Instead of arranging the content of the meals under normal conditions, it would be more accurate for the person to organize the diet himself by determining the main lines.

Iron exists in the body in two forms. One form is obtained from the destruction of red blood cells called hemoglobin, which is involved in the transport of oxygen in the body. The other form is the form obtained from the food taken. In order for the iron taken with food to be absorbed, it must be combined with stomach acids. For this reason, iron deficiencies are seen in both by-pass patients and after gastric reduction surgeries. Copper is necessary for the cells responsible for iron absorption to restore iron to the body. Iron absorption will be impaired in copper deficiency and therefore iron supplementation will not be successful unless copper levels return to normal.

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Due to the absorption of iron from the first part of the intestines, iron deficiencies are more serious in patients who have been bypassed. It should be kept in mind that iron is used in many areas of the body and a decrease in blood values is the most common in its deficiency.

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