Vision Changes Could Be Surgery Side Effects

Healthnotes Newswire (August 10, 2006)—With obesity on the rise in the West, gastric bypass surgery—a procedure that makes the stomach smaller—has become increasingly popular in recent years. Known problems caused by a gastric bypass include poor nutrient absorption (malabsorption), diarrhea, and vitamin deficiencies, and now a new report warns that vitamin A deficiency and night blindness may appear years after surgery.

Vitamin A is a fat-soluble vitamin that we get from eggs, dairy foods, and fish. The body also makes vitamin A from another fat-soluble nutrient, beta-carotene, which is found in colorful fruits and vegetables. Vitamin A is needed for a healthy immune system and normal cell division throughout the body. It is especially concentrated in the eye, where physical symptoms of vitamin A deficiency, such as night blindness and more serious vision loss, most frequently show up.

The current report, published in the British Journal of Ophthalmology, documented the cases of all of the people who came to a single eye clinic in one year. Four people were found to have vitamin A deficiency, and all of them came to the clinic because of varying degrees of limited night vision. All participants had undergone abdominal surgery: two had had gastric bypass surgery, another had had parts of his large and small intestines removed because of Crohn’s disease (a type of inflammatory bowel disease), and the fourth had had her gall bladder removed and then needed multiple abdominal surgeries due to complications from that surgery.

It is well known that abdominal surgeries can cause vitamin deficiencies, particularly of fat-soluble vitamins because they are not absorbed as readily as other vitamins. The surprising finding in this report is that most of the surgeries had occurred far in the past; in one of these cases, 44 years had passed.

“That’s the first I’ve heard of this link,” said Dr. Eugene Bernal, an optometrist in a busy eye clinic. “Vitamin A deficiency and night blindness are not common in general. We frequently prescribe antioxidant supplements that include vitamin A to our patients, especially older patients, to prevent macular degeneration. This report is interesting and I will remember to think of vitamin A when I see patients with a history of abdominal surgery.”

People who have had abdominal surgery might need to stay alert to the possibility of vitamin A deficiency far in the future. More research is needed to determine if other vitamin deficiencies, such as vitamin E (another fat-soluble vitamin) and vitamin B12 (which is aborbed into the body in a complicated way), might also occur many years after surgery.

(Br J Ophthalmol 2006;000:1–2)

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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