A patient who had a gastrectomy is at higher risk for which deficiency?

A patient who has undergone a gastrectomy is at a higher risk for vitamin B12 deficiency anemia due to the anatomical and physiological changes that result from the removal of the stomach. The stomach plays a crucial role in the digestion and absorption of nutrients, particularly vitamin B12.

After a gastrectomy, the production of intrinsic factor, a protein necessary for vitamin B12 absorption in the intestines, is significantly impaired or absent since it is primarily produced in the gastric mucosa (the lining of the stomach). Without intrinsic factor, vitamin B12 cannot be adequately absorbed, leading to deficiency over time. This deficiency can result in megaloblastic anemia, characterized by the production of large, immature red blood cells.

While other deficiencies, such as folate or iron, can also occur post-gastrectomy due to changes in diet and nutrient absorption, vitamin B12-deficiency anemia is particularly prominent due to its dependence on intrinsic factor for absorption. Therefore, patients who have undergone a gastrectomy need to be monitored closely for vitamin B12 levels and may require supplementation to prevent anemia.