People who have the terminal end of the ileum (close to the ileocecal valve) removed as part of an ileostomy or continent ostomy procedure may have lost the capability to absorb vitamin B12, which can lead to anemia and other long-term adverse effects. Normally, after loss of this section of the ileum, vitamin B12 must be administered via monthly shots.

Vitamin B12 is also available as a convenient nasal spray via prescription. (Your physician usually monitors the progress of the administration.)

If you have had surgery that involved the removal of the lower part of the ileum over a year ago and vitamin B12 has not been monitored, check with your doctor.

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