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Bariatric Surgery - OMA Obesity Algorithm 2023

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3 Nutrient Absorption GI Hormone Regulation of Caloric Balance, Food Digestion, and Nutrient Utilization Stomach (~1 foot) • Water • Alcohol • Fatty acids • Amino acids • Minerals (e.g., calcium during calcium def iciency, iron) • Some vitamins • Bile salts • Bile acids • Vitamin B12 • Some vitamins • Some minerals • Water • Sodium chloride • Potassium • Intestinally derived vitamin K Duodenum (~1 foot) Ileum (~12 foot) Large intestine (~5 foot) Before eating (during fasting): GI hormones may increase hunger • Ghrelin • NPY a Common gastrointestinal hormone actions in response to eating Hunger a The biologically active PYY and PP are expressed by endocrine cells in the digestive system. Animal studies suggest NPY endocrine cells are found throughout the small and large intestine, with NPY thus being involved in both gut-brain and brain-gut axis (bidirectional signaling). NPY is mainly described as a highly abundant orexigenic peptide found throughout the brain. Digestion • Delayed gastric emptying • Digestive enzyme release • Post absorptive nutrient metabolism Jejunum (~8 foot) The jejunum absorbs the greatest amount of: • Simple sugars • Fatty acids • Proteins • Minerals • Vitamins

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