%0 Case Reports
%T Navigating complex nutritional challenges after bariatric surgery: malnutrition, multiple nutrient deficiencies, and gastrointestinal dysfunction in pregnancy.
%A Hasan L
%A Seres DS
%J Am J Clin Nutr
%V 0
%N 0
%D 2024 Aug 5
%M 39098707
%F 8.472
%R 10.1016/j.ajcnut.2024.07.027
%X Nutritional deficiencies and nonspecific gastrointestinal symptoms such as nausea, vomiting, and poor oral tolerance are commonly observed following bariatric surgery. When these symptoms persist, especially when accompanied by malnutrition and hypoalbuminemia, may indicate an underlying inflammatory process contributing to these conditions such as small intestine bacterial overgrowth (SIBO). This case study describes a 34-y-old pregnant woman with a history of bariatric surgery, who presented with generalized swelling, persistent nausea, bloating, steatorrhea, and was found to have severe malnutrition, 18 mo after biliopancreatic diversion with duodenal switch (BPS/DS). She was empirically treated for SIBO using systemic antibiotics and was started on parenteral nutrition to prevent further calorie deficit during pregnancy. This case underlines the complexity and challenges in diagnosing SIBO after bariatric surgery that includes the creation of Roux-en-Y anatomy, including BPS/DS, and the relationship between albumin, malnutrition, and the effect of systemic inflammation on the latter two.