Question

1. Gastrointestinal surgery is a treatment method which can be used to promote weight loss. In this surgery, the size of the stomach may decrease, and parts of the intestinal tract may be removed. How might this affect the potential for a body to develop osteoarthritis?

Answer 1

The gastrointestinal tract is the site of absorption of calcium and vitamin D in the body. Vitamin D is absorbed best in the small intestine, just below the stomach. The absorption of calcium requires vitamin D. Calcium is also absorbed by an active transport process in duodenum and upper jejunum. There is also passive transport of calcium via passive transport in the large intestine.

In gastrointestinal surgery, there are portions of stomach and small intestine removed. This will cause reduced vitamin D and Calcium absorption due to lesser areas for absorption from food. Calcium is required for formation of bone. It hardens the bone matrix by forming calcium phosphate. Hence, decreased calcium absorption will lead to increase chances of bone fractures as bones become brittle.

Osteoarthritis is a form of arthritis caused by breakdown of cartilage between bones. This causes joints to rub closer, causing pain. Vitamin D is said to be linked to development of osteoarthritis. Low levels of vitamin can lead to higher risk of developing osteoarthritis, especially osteoarthritis in knee. Vitamin D is required to maintain the homeostasis of calcium and phosphate in body. It is required for regeneration of cartilage. Vitamin D and not calcium is linked to osteoarthritis, as it can repair worn joints. Hence gastrointestinal surgery do increase risk of osteoarthritis as it reduces vitamin D absorption.