Nsaids- how soon?

I will probably be sleeved in the next few months and I have to take NSAIDs to be able to actually have any mobility but I am wondering how long I should wait and have any of you reacted to NSAIDs? Opinions pls?

You've ventured over to the VSG forum lol

You'll find most on this forum from the states are told no NSAIDs after having the VSG.

For me, I had to stop NSAIDS, I believe a month before surgery, maybe six weeks before (can't remember sorry), but I had to wait 8 weeks after surgery before I could use them again.

You can talk to you doctor about prescribing you a patch instead of pills. This is safe post surgery. Won't cause stomach damage. Talk your your doctor.

NSAIDS in patch form can still give you ulcers. NSAIDS work in the body systemically.

They get in the blood stream and inhibit the body's production of prostaglandins.

Prostaglandins are natural chemicals that serve as messengers to promote inflammation. NSAIDS decrease inflammation by blocking the enzyme that produces prostaglandins.

Some prostaglandins are important in protecting the stomach lining from the corrosive effects of stomach acid as well as playing a role in maintaining the natural, healthy condition of the stomach lining.

These protective prostaglandins are produced by an enzyme called Cox-1. By blocking the Cox-1 enzyme with NSAIDS and disrupting the production of prostaglandins in the stomach, NSAIDs can cause ulcers and bleeding.

It does not matter what form NSAIDS are in when you use them.

You need to work with your team on this.

VSG was the only real option for me because I have to be able to take NSAIDs and steroids for an auto-immune condition. The general guidelines are apparently now saying no NSAIDs for VSG, but the risks are different than for RNY (I'm not sure about DS) and it can be a risk/benefit analysis for taking NSAIDs after surgery, but that's a medical decision you and your team need to make, along with what protections can be used (PPIs) and how soon you can start taking what.

I personally was cleared for OCCASIONAL NSAID use when I was cleared for a full diet, so long as I'm on PPIs (which I have to be for my auto-immune meds), and it's better if I take them with some food. I've taken ibuprofen about 3 times in the last year since my surgery, and Excedrin (has aspirin) about 6 times. I'm finding that my overall health has improved enough that I don't need the levels of NSAIDs I did before surgery. And my auto-immune doesn't respond well to NSAIDs so we had to move on to another type of treatment, so I don't take the risk for the NSAIDs since they're not going to help much.

Depending on which of your joints are affecting your mobility, you may want to ask your team about Voltaren gel. I use it for my hands and feet, it doesn't help much with my knee. It's an NSAID but it's a gel that you use topically so only a very minute amount of the NSAID gets into the bloodstream.

This is absolutely NOT an area that you should be seeking input from other patients to base your decision on. Your medical condition is as unique as you are, and only your medical team can tell you if it's worth the risk to go against the generally accepted guidelines and take NSAIDs. The "reactions" to NSAIDs post-WLS are not really "reactions" or tolerance issues (though those can happen also), the main risk is perforated ulcers.

I just wanted some input from actual VSGers..... will be consulting with surgeon soon... and the gels do not work and nothing does actually except Naproxen. Thank you. Hey I love your blog and info.

I understand. When you rely on NSAIDs and the like for pain control and mobility, it's scary to think of life without them. I started aggressively seeking a diagnosis when I realized I was taking well over 10 grams of ibuprofen a week. Luckily it hadn't damaged my kidneys or caused an ulcer. My rheumatologist tried me on several prescription NSAIDs with no better relief than the ibuprofen. (I can't take naproxen, it causes fever blister outbreaks for me, and that makes me sad because it's a fabulous drug.)

You will hopefully find that you don't need as much as you lose weight. It's amazing how much better your joints feel when you drop 100#+. Even with my pain returning after stopping my auto-immune meds, I still am more mobile and feel better than when I was that heavy.

Just make sure everyone on your treatment team is on board with the surgery and the medication advice post-op. I had to juggle several appointments with my rheumatologist, my PCP, and my surgeon to ensure that everyone was on the same page.

And thanks so much for your feedback on my blog. I don't post as often as I'd like, but I'm trying to do better. :)

The current ASMBS guidelines recommend no NSAIDs for VSGers.

Every surgeon has different requirements, and so those of us that use NSAIDs all were able to start at different times, while those of us who do not never resumed taking them. Weight loss and the new diet will help with inflammation, though, so you might find your medication needs severely reduced.

In pill form? Never is what we are told. BUT you CAN take them in transdermal patches or creams that are absorbed through the skin. I suppose if you really have no other choice you could take them buffered with food .. but I wouldn't want to even try it until your healed ... say 10 weeks out (not really sure about that... but if a bone can mend in 10 weeks the stomach should be too?)

As always .. this is really something to discuss with your surgeon.