ASMBS Biliopancreatic Diversion with Duodenal Switch Guidelines

2019 ASMBS Guidelines for BPD / DS
Multivitamin (MVI)
Thiamin	At least 12 mg / day *
Folic Acid	400 – 800 mcg / day from MVI
	800 – 1,000 mcg / day total (female, child bearing age)
B12	Oral: 350 – 1,000 mcg / day
Vitamin D	3,000 IU (75 mcg)
Vitamin A	10,000 IU (3,000 mcg) / day
Vitamin E	15 mg / day
Vitamin K	300 mcg / day
Copper	2 mg / day from MVI
Zinc	16 – 22 mg / day from MVI
Zinc to copper ratio: 8 – 15 mg of zinc for every 1 mg of copper
Iron (from all supplements)
At least 18 – 60 mg / day **
CANNOT take with Calcium
Calcium (from food and supplements)
1,800 – 2,400 mg / day
Take in divided doses
Calcium Citrate may be taken with or without meals
Other
Protein (often individualized)	Minimum of 60 g / day with some patients needing higher amounts of 80 – 90 g / day
Fluids (often individualized)	At least 50 oz / day to ensure adequate hydration
* At risk patients: rapid weight loss, protracted vomiting, the need for parenteral nutrition, excessive alcohol, neuropathy, encephalopathy, and/or heart failure. At risk patients need at least 50 – 100 mg of thiamin daily.

** Low risk patients (males and patients without a history of anemia) need 18 mg of iron from their multivitamin. Higher risk patients (menstruating females who have had VSG, RNY, or BPD / DS or those with anemia) need at least 45-60 mg of iron daily.
Information adopted from Mechanick et al SOARD. 2020; 16:175-247

2019 ASMBS Guidelines for BPD / DS
Multivitamin (MVI)
Thiamin	At least 12 mg / day *
Folic Acid	400 – 800 mcg / day from MVI
	800 – 1,000 mcg / day total (female, child bearing age)
B12	Oral: 350 – 1,000 mcg / day
Vitamin D	3,000 IU (75 mcg)
Vitamin A	10,000 IU (3,000 mcg) / day
Vitamin E	15 mg / day
Vitamin K	300 mcg / day
Copper	2 mg / day from MVI
Zinc	16 – 22 mg / day from MVI
Zinc to copper ratio: 8 – 15 mg of zinc for every 1 mg of copper
Iron (from all supplements)
At least 18 – 60 mg / day **
CANNOT take with Calcium
Calcium (from food and supplements)
1,800 – 2,400 mg / day
Take in divided doses
Calcium Citrate may be taken with or without meals
Other
Protein (often individualized)	Minimum of 60 g / day with some patients needing higher amounts of 80 – 90 g / day
Fluids (often individualized)	At least 50 oz / day to ensure adequate hydration
* At risk patients: rapid weight loss, protracted vomiting, the need for parenteral nutrition, excessive alcohol, neuropathy, encephalopathy, and/or heart failure. At risk patients need at least 50 – 100 mg of thiamin daily.

** Low risk patients (males and patients without a history of anemia) need 18 mg of iron from their multivitamin. Higher risk patients (menstruating females who have had VSG, RNY, or BPD / DS or those with anemia) need at least 45-60 mg of iron daily.
Information adopted from Mechanick et al SOARD. 2020; 16:175-247

Subscribe