Background: Iron deficiency anemia is a common complication of gastric bypa
ss. The authors assessed the value of taking vitamin C with oral iron in co
rrecting deficiencies in iron stores and anemia postoperatively.
Materials and Methods: Iron absorption tests were performed on 55 patients
3.2 +/- 2.0 years after isolated gastric bypass to identify those at higher
risk for the late development of anemia. Twenty-nine of this group agreed
to a therapeutic trial of iron alone or with vitamin C over a P-month perio
d. All 55 patients were followed up for 27.1 +/- 1.0 months following the s
tudy.
Results: The iron absorption test identified patients with low iron stores,
as indicated by low serum ferritin, and those with sufficient absorption s
urface to benefit from oral iron. The addition of vitamin C appears to enha
nce the therapeutic effect of iron by correcting ferritin deficits (P < 0.0
1) and anemia(P < 0.05). Differences in intestine length bypassed by the op
eration (10 vs. 100 cm) did not affect late ferritin and hemoglobin values.
Conclusion: This study suggests but does not prove that the addition of vit
amin C to iron therapy after gastric bypass is more effective in restoring
ferritin and hemoglobin than iron alone. These results are in contrast with
the outcome 22.8 months later, when similar to 50% of study patients were
again anemic. Closer follow-up of patients is urgently needed.