Ulcers--caused by citric acids or?

At a support meeting Tuesday, I listened to one of the "poster guys" of this group. He had RNY a little over a year ago. He's lost 140 pounds and has stated at these groups he followed protocol closely.  He seemed to be very doing well. Last month I did not see him, and he told his story Tuesday night.  He was getting ready for the meeting last month, and "did a number 2" before his shower.  He said he had "tar" coming out of him. He said he had a burning sensation in his "pouch area" for a couple of hours about a week earlier.  He called his doctor, and was told to go to the ER immediately.  He was scoped, and showed colored photos of his pouch, showing ulcers.  He said this past summer he had been eating a lot of acid type of fruits, like pineapple, oranges, etc.  He also said he had a "passion" for drinking the ruby grapefruit flavored Crystal Lite.  He wondered if this flavor of Crystal Lite may have been the issue, as he said he drank one half to one gallon a day on hot days.  He wondered, as he noted that the clear plastic container he used to mix the Crystal Lite was discolored--like it was permanently stained.  He spent 2 days in the hospital. The docs wanted to do a tranfusion, but he said he only wanted the transfusion if actually needed it, not as an extra precaution.  He came home has has to take a medication similar to Nexium twice daily, and has to return in a couple of weeks for another scope.  He says he feels much better. Could high consumption of acidic fruits or the grapefruit Crystal Lite cause this issue at one year post op?   DAVE

Consumption of acidic foods do cause GERD. If he had burning, I'm assuming that that is what caused the ulcer. Tomatoes, bananas, citrus fruits, some (and very few) Crystal Light flavors are high in citric acid, etc cause a build up of stomach acids and bile. If he watches his diet and takes the medicine, his ulcers should heal fine. I've had some doozies of some ulcers and I have to watch my diet carefully. I also take Nexium twice a day.

This guy is honest and makes very good comments at this monthly meeting. In fact, he's repaired Vitalady's motorhome twice when she was in southern CA a couple of years ago.  He's never complained about any Gerd, or other issues. He comes and talks with me at every meeting, as well as participates in group discussions.  I citrus fruits are a food to eat with caution with new post ops, but I wondered about 1 year post ops. This guy admittedly says he ate a lot of oranges and tomatoes, but this was during the past 3 months when it was hot--and he had to be 10 months or so post op at the beginning of summer.  He as a pretty firm belief the his high consuption of the ruby grapefruit Crystal Lite had a large component with his ulcer.  Again, he says he feels much better with the Nexium, and he has the same exact demeanor as I've known for over a year--so I assume he's feeling much better now.  Just wondered if anyone else had any similar experience. DAVE

I understand the "no complaints about GERD". I actually have no symptoms with that either...well, other than ulcers. Glad he's feeling better.

I was wondering about that...I posted a question several months ago about the acid in fruit, because I like to put lemon in my water and was wondering if the acid could cause an ulcer  

It IS possible. I was two weeks out and developed an ulcer (not fun at all). Ended up back in the hospital for the scope and dehydration. I was doing everything by the book and still developed one. Ulcers can happen to ANYONE.

I just had a perforated ucler in August...  I'm 2 years out.  I spent 5 days in the hospital. it was some of the worst pain I've ever had.

I have been taking prevacid all along and will continue with the prevacid solutabs for life...   I also get Carafate for the ulcer repair but that's not lifetime.

I asked the doctor what causes ulcers.. in my case they do not know

I do not and have not taken NSAIDS since before surgery
I have not taken steroids in a year or so
I do not smoke cigarettes
I drink alcohol but not hard liquor and not straight and not daily and not on an empty stomach


I'm told that STRESS can really affect us and cause ulcers and that other than the above list H. Pylori bacteria is a huge cause of ulcers.

mine was called a marginal ulcer as it was near where my pou*****ision was made.

do I think that the acidic food caused the problem... I doubt it.. I doubt that the crystal light was the cause.

My surgeon's nurse was at this meeting. She asked him twice if he had an major stress in his life.  His answer was no--he always seems like an easy going person to me.  She did ask him one more time if he was subjected to any regular stressors.  DAVE 

If someone takes NSAIDS, they thin the lining of your stomach and then when the stomach comes in contact with acid - not citric acid but stomach acid, an ulcer will form.  I find it very unlikely that citric acid could ever be that strong to cause an ulcer, especially a bleeding ulcer.  Did he say if he was biopsied for HPylori?  The bacteria that causes 80% of ulcers.  IF this was possitive, then any stomach acid again could eat away at the stomach lining that is weakened by that bacteria.  Was he taking steroids of any kind?  Was he taking celebrex or mobic?  Did he take Pepto bismol?  There are alot of things out there that people dont' realize can cause ulcers.

Also, if the ulcer was that bad at 1 year out,it was probably growing for some time.  They start small and grow.  He should have been taking a PPI from the day he came out of surgery for the first year to protect his pouch so this wouldn't happen.  If he didn't take a PPI for the first year, that is a big offender in ulcers in newbies

Like I said, this guy was the "poster guy" for RNY. He did everything by the book. He took no medications after 2 weeks post op, except for Prilosec, that all my surgeon's patients take for 90 days post op.  He was off of all scripts to my knowledge. My surgeon's nurse must have asked him 20 questions after he spoke.  He was not taking NSAIDS either.  He had not been ill at all. First sign of any issue was one hour or so of moderated pain in his abdomen a few days before he had the "tar stool".  I was only posing his question about citrus and this flavor of crystal lite, as this was his concern.  He did state he ate a lot of cold citrus fruits during this summer and the fact he consumed large quantities of this ruby grapefruit Crystal Lite.  DAVE