Why we can't take NSAIDS

Lora's post about her friend with an ulcer prompted me to post this.

Now, of course we CAN take NSAIDS if we choose to.  But here is why  most of us don't.

NSAIDS put you at risk for ulcers. They do that to everyone, not just RNY folks.  But ulcers are particularly dangerous to us.  If you get an ulcer in your pouch, even a small one, since your pouch is a lot smaller than a normal stomach, it will cover a much greater percentage of your pouch.  If you get an ulcer in your old stomach, docs can’t even do an endoscopy to see it.  They’d have to do surgery.  Also taking a medication designed to coat the stomach wouldn’t help an ulcer in the old stomach because nothing you take by mouth goes in there.

We really, really don’t want an ulcer.

NSAIDS can cause ulcers because they cause the lining of the stomach (the old stomach and the pouch) to thin out.  This does NOT happen when the medication enters the pouch or touches the pouch.  It happens when the medicine enters your blood stream.  That’s why you can get ulcers in your old stomach.  NSAIDS taken by mouth don’t touch the old stomach but can still cause ulcers there.

Any way you take an NSAID – pill, liquid, shot, IV, patch, gel – it gets into your blood stream.  If it does not get into your blood stream, it will not give you any pain relief or relieve inflammation.  Many docs don’t seem to understand this, though I don’t know why since they have to take pharmacology in medical school. 

Many docs that are not bariatric surgeons also don’t know RNY patients should have not NSAIDS so be very vigilant about what other docs try to give you.  I finally started saying I am allergic to NSAIDS.  They seem to listen to that more.

Some surgeons say it’s OK to take NSAIDS on a very limited basis if you really need them as long as you also take Nexium or something like that to help protect your stomach.  Others say it’s never worth the risk.  A few say it’s OK to take them whenever you want, but I think they are nuts.  But what I really think is that we need to weigh the benefits of taking them against the risks.  Is the pain of your bad back or menstrual cramps or whatever worse than the pain of an ulcer would be?  If so, take the NSAID.  But take it with something to protect your tummy.

Now, how likely it is that taking NSAIDS, especially rarely, will cause an ulcer, no one can say.  I know people that took just one dose and got an ulcer.  I know people that took them many times and had no problem.  So it’s just a matter of whether or not you wanna chance it.

 I love when I read a post and walk away knowing something new...Thanks Kelly!

Kelly,
Do some RNY patients wear medical braclets/necklaces that say "NSAIDs Allergy"?  I like your idea about telling your doctor that you're allergic to NSAIDs. 

Thanks for educating me once again!

Some people wear medical bracelets.  I've never actually heard anyone say that their bracelet says "NSAIDS allergy" but they might.  Mine says "No  NSAIDS" but "NSAIDS Allergy" might have been a better choice of words.

 This is the freakiest thing I have seen on here. Why my post went under someone else's profile I have no idea?!

Kelly,

I am a nurse as you are aware.  I met someone who had an ulcer from taking baby ASA.  She thought  a Baby Aspirin what could that do!  An Ulcer right at the opening of the pocket!  So be careful.  I rarely take an NSaid only with food and very rarely.  Actually extra strength tylenol has worked for me.  Take care all Patty

Hey, maybe you can answer a question for me.  Do you know why it is that many nurses, and maybe even some docs, don't seem to realize that Toradol is an NSAID?  I've heard stories from many people that went to the ER for various things and they tried to give them Toradol after they specifically said they could not have NSAIDS.  In some cases, the nurses that were trying to administer the Toradol tried to say it was not an NSAID or had to go look it up to see because they didn't know and apparently didn't believe the patient. 

I understand that no on can possibly know everything about every single drug out there.  But Toradol seems like a pretty common drug and seems to be used in the ER fairly often for pain.  Before my RNY, I was given Toradol in the ER once for a migraine.  So it seems to me that they should at least know it's an NSAID.

 This is going to be the hardest for me. I take excedrin almost everyday for various reasons. Tylanol just doesn't work for me. Part of the reason why I would like to have a DS but tricare refuses to cover it now and I'm not waitin 2-3 years for them to ok it. I've been too fat for too darn long. 

I'll adjust though. I'll ask my dr for something for my painful periods.