Needs a little help, please

Greetings all, I know that NSAID's are a definite no-no, but I also recently saw a post that some OTC pain relievers now contain combinations of NSAID's and aspirin (which is also a no-no). Is there is list compiled of food and medicines that should be avoided?

You can take NSAIDS just don't abuse them.

--g

NSAIDs can cause ulcers in anyone.  The reason given for RnYers not to take NSAIDs is their remnant stomach which can still get an ulcer but can't be (easily) scoped to see.  We don't have a remnant stomach but we can still get ulcers in our tiny stomach so I believe NSAIDs should be taken cautiously and after a risk benefit analysis is done. 

Most DSers will say they can take NSAIDs.  For me, I would take them if I had to, but I avoid them as much as possible.

~Becky

An even more important reason that RNY'ers can't take NSAIDs is that the tissue at the stoma is exposed to small intestine contents, which is not normal for the stomach lining, and also that the stomach in that area has lost some of its blood supply (from being divided to form the pouch) and is more fragile. So they are at higher risk for ulcers in that area.
     We have no such connection, as well as no blind stomach. Many DS'ers do take NSAIDs, but it's important to stick to the recommended dosage, never go over, or better still, take as little as possible, just to play it safe.

Larra

Thanks Larra.  That is important to know.

~Becky

I have a list.

NSAIDS are dangerous drugs for anyone. The action of the drug is the same. I forfeited my stomach to them when I had WLS, but the damage was done in the 80's, early 90's before I knew better.

I was just talking to a normie guy who is one of the luckier ones. He got nose bleeds. I got ulcers and eventually, my stomach was a "bag of pits" according to the GI doc, pre-op. Those who don't get any pain at all can still have a gastric bleed.

I compiled this list years ago, so there are newer drugs not on it.

The paragraph at the bottom was written by one of "us", but RN in WLS office, as well as geriatrics.

****



http://www.uclabariatrics.mednet.ucla.edu/recovery/recovery_discharge_offlimitmed.htm

(also, but not all inclusive)





DRUGS THAT CAN DAMAGE THE POUCH
Advil.............

Aleve............

Amigesic............

Anacin............

Anaprox................. Ansald................

Anthra-G.............. Arthropan............. Ascriptin.............. Aspirin................ Asproject............... Azolid............... Bextra ................

Bufferin............

Butazolidin...........

Celebrex........... Clinorial................

Darvon compounds................. Disalcid................. Dolobid............... Erythromycin............ Equagesic................ Feldene.............. Fiorinal.............. Ibuprofin.............. Indocin............... Ketoprofen.............. Lodine................ Meclomen...............

Midol..............

Motrin................. Nalfon...............

Naprosyn.............

Nayer...............

Orudis................

Oruval..............

Pamprin-IB............... Percodan.............. Ponstel................... Rexolate.............. Tandearil............. Tetracycline..........

Tolecin.............

Uracel............

Vioxx........

Voltaren............

ALL "NSAIDS" (*see below for the Cox 2 Inhibitors)



DRUGS THAT ARE CONSIDERED SAFE..........

Bendaryl...................

Tylenol ..............

Dimetap..............

Robitussin..........

Safetussin............

Sudafed..........

Triaminics (All).........

Tylenol (cold products).......

Tylenol Ex Strength..........

Gas-X ..........

Phazyme...........

Imodium Ad..........

Colace.......

Dulcolax-Suppositories.........

Fleet Enema..........

Glycerin-Suppositories..........

Milk of Magnesia.........

Peri-Colace...........

* copied with permission:

Bextra is the newest, next generation of NSAIDS. It is simply an
anti-inflammatory with no compound to aid in the protection of our GI systems.

I want to help everyone understand the reason NSAIDS are dangerous for us. Contrary to popular belief, it is not just that they are "pouch burners" as the industry wants us to believe. It goes much deeper than that. According to an article published in the June 1999 New England Journal of Medicine, NSAIDS, once absorbed into the blood stream cause a chain of chemical reactions that affect the prostaglandins and this in turn reduces the production of mucus in the GI system. The mucus is what
lines our GI system and protects our pouch and intestines from damage.


If the mucus production is reduced, this would allow ANYTHING, including eating something with too sharp of an edge or foods that are extremely spicy, to inadvertently begin a marginal ulcer. The best answer is to avoid NSAIDS at all cost. Taking an H2 receptor drug such as Prilosec, Prevacid or Nexium is only a band-aid and no guarantee that it will protect you.

If you are desperate to try an NSAID, my recommendation would be Arthrotec. It is an NSAID with a prostaglandin compound in it that tries to prevent the chemical chain of events I was speaking of in the above paragraph. There are still no guarantees. You are at risk for marginal ulcers any time you take an anti-inflammatory medication.

Ultram is a mild narcotic and can be habit forming, so I would not
recommend more than a six week course of it at any one time.

Michele (with one L)

Van Hook-Troesch, RN

Great info Michelle.  You should cross post that to the main and RnY forums.

~Becky

Feel free to post it. As a victim of NSAIDS without warning, it's really important to emphasize the actual formula is dangerous. Period.

Back in the 80's, I was taking one kind to ease the back pain of a car accident and another as a migraine prevention. But my stomach issues really began in the 60's, continued thru the 70's. So, I just finished the job with 2 per day. I guess I'm really lucky that I just made new ulcers and none perforated.

More for some than others, as I said, this guy who was a normie had nose bleeds. 3rd day.

Their action is to "thin", so while they're wandering around in your BLOOD to find your booboo, they are thinning ALL tissue and the mucosa is more easily victimized than say, skin.

So, in this guy's case, his nasal mucose screamed UNCLE before his stomach was damaged.

Michelle makes a valid point. GI bleeding is a well known potential side effect of all NSAIDs, and that has nothing to do with ANY kind of wls.
     However, NSAIDs are also taken without issue by many people. They are among the most commonly prescribed drugs in the USA. Obviously no one should exceed the proper doses, and if someone does have a problem with them they should stop taking them immediately and find some alternative. And as explained above, people with RNY shouldn't take them at all.
     I think, though, that writing off an entire class of drugs that help so many people with pain and inflammation and that are non-narcotic would be going overboard. Perhaps someday the FDA will disagree with that reasoning and take them off the market, but til then, I'll take them if/when I need them - in the smallest possible dose and for the shortest possible length of time.

Larra

I totally agree.

I just always make the offset point so that if ppl take them and have any pain or random unexplained bleeding, they stop taking them and get to their doc soonest.