CAUTION - Ibuprofen users!!!!

Hey all.... just back from a 4 day stay AGAIN in the hosp for a GI bleed. wanted to post here what the diagnosis was too....it's using Ibuprofen! it appears that a RNY patient, when the small intestine is 're-arranged' for the bypass, ends up with 'pockets' -- or so my GI doc says. what that can mean for some of us -- not all in his opinion -- is that when you take an Ibuprofen (even a coated one) it of course goes right thru your pouch and stoma and will lodge in one of those 'pockets.' this can cause that area where the pill lies to become ulcerated and perhaps to bleed. if you took 6 like I did last Fri am to help cut down on lower back pain (yes, yes I know...I'm an idiot!) then all 6 will most likely cause bleeding. not always, and not for sure...but in my case that was the cause of my GI bleed. they did a full workup of scoping the "in" and "out" portholes on this old body and found nothing...hence the further study by the hosp GI folks and the finding of my taking too much Ibuprofen. and yes, I know that I'm down 189 lbs and shouldn't be taking the size of dose that I used to take...but all I did was not think....(famous last words, eh?) so....a caution to one and all...if you DO take this item be forewarned.... Dx , if you know ANYTHING more on this topic, it'd sure be appreciated by me !!! Jim

Although it's completely conceivable that a tablet of ibuprofen could become lodged in a "pocket", you don't need long-term physical contact with the tablet to develop GI side-effects, including ulcers and bleeding.  Liquid NSAIDs or even the handful of injectable NSAIDs can still cause GI damage.  This occurs not-infrequently in people who haven't had RNY; WLS patients are simply even more likely to suffer an adverse reaction with medium-to-long-term NSAID use, or, in your case, just one very high dose. My own surgeon made it clear than NSAIDs were not an option for me at any time in the future (unless, of course, the new higher risk of GI side-effects were outweighed by the beneficial effects; needless to say, OTC self-medication with a NSAID doesn't come under this category.) All NSAIDs (almost every non-narcotic pain reliever except for Tylenol [acetaminophen, paracetamol]) exert their effects by inhibiting the COX enzyme, which prevents the synthesis of prostaglandins.  Some prostaglandins cause pain and inflammation, which is why NSAIDs are so good at what they do. Unfortunately, the same COX enzyme produces other prostaglandins which protect the mucosal barrier of the stomach and intestines from damage by stomach acids and digestive juices, and therapeutic doses of NSAIDs are strong enough to reduce levels of these protective prostaglandins in the GI tract, and in some, lead to bleeding or an outright ulcer. Almost every NSAID happens to be an organic acid, so as you point out, there's also the issue of topical irritation to the stomach or intestinal mucosa, especially if a tablet gets lodged in the gut after swallowing. /Steve

wow...great info -- thanks so much!  never realized (like many others I suspect!) what I was swallowing.... will find a new way to lessen back pain....for sure! Jim

Jack Daniels.  (just kidding)     Well, sort of... 

Also, if you do use Tylenol, be sure not to overdose on it.  Do not have more than 8 tablets of extra strength Tylenol in a 24 hour period.

Sheesh...am I ever an idiot!  Just googled "megadose of ibuprofen" and got this link -- http://www.medpagetoday.com/Gastroenterology/PepticUlcerDise ase/tb/2046 It's from the same Hosp that I was in, the same GI team too....gosh I feel like an idiot! However, that said....I think I'll try that Jack Daniels cure! Jim

Jim, Ouch!

Swallowing 6 ibuprofens, even for someone with "Un-Edited" Guts Is begging for an ulcer! The Ulceration risk for Non-Ops Is pretty high with NSAIDs.

Still higher for those who have had RNY. I’ve been on prescription strength NSAID- Meloxicam (Mobic) 15 mg

For about 6 months now. My doc has me take it with a Nexium to offset any Irritation potential. So far, so good. With all of the posts claiming- "RNY’ers can NEVER Take NSAIDS!!" I would have thought you’d have caught this one. Although, many RNY’ers do take NSAIDs on Doctor’s Orders, They just usually have to take them in conjunction with - proton pump inhibitors (PPI) which block the production of acid by the stomach. Such as- Aciphix, Prilosec, Protonix, Prevacid, or Nexium. Check with your doc for better solutions for the back pain. Take it easy on yourself! Best Wishes- Dx

Concerning NSAIDS, I have had a heart condition (heart bypass & heart attack).  I do take a low dose aspirin (under doctor's orders).  I always take it with milk.  I will drink the milk for a few minutes then take the pill with milk.  I will then take some more milk a few minutes later.  I want to coat the pouch and GI track as much as possible.  Brian

It's interesting that this topic came up today because I was just talking about it at our support group.

Lots of people were unfamiliar with the "don't take ibuprofen" rule. It turned out that lots of them had vaguely heard not to use NSAIDS...but nobody knew what that meant. Aleve, Ibuprofen etc. Sometimes I think we get lost using medical jargon when we should be using our common touch.

Personally, I keep a bottle of liquid vicodin on hand. Sure, it's not an anti-inflamitory but hell, when that root-canal shot wore off and I couldn't take the IBU it sure did the trick. THAT BEING SAID...don't get hooked on the crap.