[Drugs malabsorption after bariatric surgery]. / Zaburzenia wchlaniania leków u chorych po operacjach bariatrycznych.

ABSTRACT

Along with the increasing prevalence of obesity surgical methods of treatment are becoming more accessible. The success of bariatric surgery results from the failure of conservative treatment of obesity through diet, exercises and behavioral changes. Such behaviors, including less effective drug therapy, are responsible for rather small and unstable weight reduction. In contrast, surgical treatment restrictions limiting the amount of food intake, excluding treatments and mixed treatments usually give a spectacular effect, though it is not always consistent with the previous assumptions. Most of us, however, do not realize the risk of the consequences that these treatments bring. The change of the absorption of oral medications, vitamins, microelements, often change the way they are metabolized and it forces ones to change the form of the drug, the way they are taken, which undoubtedly is associated with higher costs of later treatment. Many clinicians are unaware of the need for lifelong supplementation of some vitamins and microelements, as well as the need to modify pharmacotherapy in patients who have undergone this type of operations. This article presents examples of the best known and described changes in the absorption of drugs and micronutrients and explains how well oriented the internist ought to be when qualifying a patient to undergo this type of treatment. The described topic is interesting, but also controversial due to the fact that it corresponds closely with the surgical specialties, quite spectacular in their effects and behavioral specializations, that in many years time will be looking after the patient who underwent the surgery, but is still sick.