Table 1.
Summary of alterations in drug absorption processes influencing oral drug availability, sorted by type of surgical procedure [53]. (↑ = increase; ↓ = decrease; - = no effect).
| LAGB 1 | SG 1 | RYGB 1 | |
|---|---|---|---|
| Gastric pH | - | ↑ | ↑ |
| Gastric volume | - | ↓ | ↓ |
| Gastric emptying | - | ↑ | ↓ |
| Exposure to gastric digestive enzymes | - | ↓ | ↓ |
| Small intestinal bacterial overgrowth | - | ↑ | ↑ |
| Intestinal surface area for absorption | - | - | ↓ |
| Intestinal transit time | - | - | ↓ |
| Exposure to metabolic enzymes and drug transporters in the intestinal wall | - | - | ↓ |
| Exposure to bile acids | - | - | ↓ |
| Enterohepatic cycle | - | - | ↓ |
1 Abbreviations: LAGB = laparoscopic gastric band; SG = sleeve gastrectomy; RYGB = Roux-en-Y Gastric Bypass.