Iron deficiency
When describing the surgery, the "Roux limb" is the efferent or antegrade limb that serves as the primary recipient of food after the surgery, while the "hepatobiliary" or afferent limb that anastomoses with the biliary system serves as the recipient for biliary secretions, which then travel through the excluded small bowel to the distal anastomosis at the mid jejunum to aid digestion. The altered anatomy can contribute to indigestion following surgery. The procedure has also been associated with an increased incidence of iron deficiency anemia. Iron deficiency anemia develops in up to 45% of people who have had a Roux-en-Y anastamosis.