PPI's....what cha' think

Did you all catch the news about PPI's???? 

http://abcnews.go.com/Health/MensHealthGERD/fda-warns-fractu re-risk-heartburn-drugs/story?id=10746531

What are you going to do?  Personally I think I'm going to work on increasing my calcium intake to see if I can offset the risk of fractures. 

What are your thoughts on this?

Edie

I used to take Aciphex and Protonix but stopped the day before I had surgery and haven't taken them since.  I do know that I need to up calcium, though, because I don't do a lot of dairy as I'm allergic (not like go into shock allergic, though, so do have some).  

PPI's were a 'rule' we were given w/ surgery.  I've rarely missed a day since surgery and before surgery I was on Aciphex.  Are you a rebel, or did your surgeon not tell you about PPI's, I thought everyone was on them.

As far as calcium, I've heard and read that we do not absorb it very well and it's really important that we supplement post op.  Do you supplement w/ calcium?  Do you get bone density tests???  Not being judgemental here, just worried about your bones :).

I was not told I had to take them post-op.  I was on them because I had such bad GERD, but like I said, I stopped all meds the day before surgery.  Had surgery.  They had me on Prevacid for like a week or so and that was it.  I haven't taken Aciphex or Protonix since then.  Haven't had any reflux issues since WLS either.  So, not a rebel, in this case.

I DO need to supplement with calcium.  I know that, but I got out of the habit a little while ago and need to start taking them again.  I worry about my bones, too!!   I've never had a bone density test, either.  Hmmmm...maybe I should request one.  My PCP is pretty good about my WLS stuff.  I'll talk to her about it.

It's funny how different all the doc's are.  I was told I had to be on Prevacid for life because our new little stomach's were more prone to ulcers, so it is used as a preventative.

Hurley has patients do Prevacid or Prilosec for 1 year post-op.  Some docs do 3 months or 6 months.   But emerging science is showing that PPIs help reduce the risk of ulcers in the pouch long term.

As for the bone scan.  YES!  You're way overdue for this.  We should have one within a year of surgery, then every year after.  Because of our malabsorption of vitamins, we're at high risk for osteoporosis after RNY.  We essentially do not absorb any calcium from food at all (both absorption spots are bypassed) -- so we have to rely 100% on supplements.  "Malabsorption Syndrome" is the diagnosis code for the DEXA scan for insurance purposes.

So much has changed in the 5 years I've had surgery.  At the time, in 05, Hurley did not require me to be on Prevacid for more than a few weeks.  Seriously.  Hmmmm.....

Hi Ya'll,
I had my bone density test last year....I think it is called a DEXA scan...I was told I have OsteoPenia, ( I have a thinning of the hips)  the first cousin to OsteoPorosis. I was going to do the once a year IV so I didnot have to worry about it again for a year. But, with the diagnosis of breast cancer shortly after that it was put on hold. I was told that if we take magnesium it will help to keep more of the calcium...

Now I am concerned with taking the Reclast...toss up....Don't take the meds and bones get thin or take the meds and break bones any way.....  :-(

thanks for sharing
I did not see this this am.
And it is very helpful

This isn't anything new, actually.  Here's the scoop...

Calcium carbonate - the most common type of calcium on the market - requires an acidic environment within the stomach to break down pills before it can be used by the body.  So PPIs eliminate the natural acid in a normal stomach... therefore decreasing the effectiveness of calcium since it can't be fully broken down for use.

Calcium citrate -- which is what we need to be using after WLS -- does not require the acid for break down. Citrate is water soluble and will dissolve in a glass of plain old tap water (which is actually more alkaline than acidic).  Therefore, PPIs don't really  have any bearing on how calcium citrate is utilized by the body since acid isn't needed when using this form of calcium.

The other thing that is different about us is our pouch configuration. Pills don't hang out in our stomach like they used to.  In a normal stomach, pills can be in there for an hour or two and be broken down by gastric acid as it tumbles around in the stomach.  In our pouch, things just flow right through. So if you take a pill with water, it's not staying in the pouch for more than a minute or so (probably less) -- and then it'll travel directly to the small intestine for breakdown and utilization. 

So when we hear stories or science about how pills are used (or not used) based on the conditions within the stomach, we need to take our altered anatomy into account and think about how those conditions are different for us now.

I do 2000mg calcium citrate per day.  Initially it was because I was taking Depo Provera - the birth control shot - which is known for leaching calcium from bone.  So I opted for the higher end of the standard recommendation for post-RNY (1500-2000mg/day).  Now that I'm off Depo, I could drop down to 1500mg/day.  Except I was just diagnosed with Osteopenia - a result of too many years on Depo - so I'm sticking with the higher daily dose to see if my bones will repair themselves.

Pam