Published in UAB Insight, Winter 2008
Helping Patients Manage Bariatric Surgery Issues
In 2006 more than 177,000 morbidly obese Americans underwent bariatric surgery, which substantially reduces the risks and severity of obesity-related comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemias, and obstructive sleep apnea. UAB’s Postsurgical Bariatric Medicine Clinic offers options to help this growing pool of patients maintain weight loss and manage adverse effects associated with weight-loss surgery.
“Our program is designed to care for patients who have undergone surgical procedures for weight reduction and who may need assistance managing the potential long-term nutritional, gastrointestinal [GI], and weight issues associated with bariatric surgery,” says gastroenterologist and nutrition scientist Jeanette N. Keith, MD, who directs the clinic.
Bariatric procedures can be restrictive, malabsorptive, or a combination of both. All carry risks of adverse side effects such as protein, vitamin, and mineral deficiencies, food intolerances, and nausea, vomiting, and diarrhea.
Comprehensive Care
The multidisciplinary clinic, which operates as part of UAB EatRight Weight Management Services, provides GI assessment and intervention, nutritional assessment, dietary evaluation, and weight management. GI assessment and intervention may involve traditional endoscopic evaluation or, when necessary, wireless capsule endoscopy.
“If a patient has unexplained iron deficiency anemia or obscure bleeding, we use capsule endoscopy, in which the patient swallows a wireless capsule with a camera tip on both ends,” Keith says. “Within 8 hours the capsule travels through the small bowel and takes images that guide targeted interventions.”
Tailored Services
Other clinic GI services include hypoglycemia evaluations and management; absorption studies; hydrogen breath testing for diagnosis of bacterial overgrowth of the small bowel or rapid food transit through the small intestine; and, when indicated, total parenteral or enteral nutrition.
“As part of the clinic’s nutritional assessment, we offer testing, evaluation, and management of vitamin and mineral deficiency and anemia. We measure patients’ body composition using bioelectrical impedance analysis, a highly accurate method of screening body fat,” she says. “Patients work with a registered dietician in one-on-one consultations to create individualized meal plans that are periodically monitored and evaluated.” A personal trainer is available to help patients develop home exercise programs.
“People who participate in EatRight services also have opportunities to enroll in clinical trials designed to improve outcomes before and after bariatric surgery,” Keith says. “Our goal is to develop treatment plans to help patients and their physicians successfully manage the long-term effects of weight-loss surgery.”
Physician referral is required for access to the clinic. Visit the Postsurgical Bariatric Medicine Clinic Web site at www.uabhealth.org/bariatric for more information, including patient referral forms for physicians.
For more information:
Dr. Jeanette Keith
1.800.UAB.MIST
mist@uabmc.edu