Question

Perfect! I will try to email/call my doctor today. (It would be nice to have an updated list of the do's and don'ts since information is ever changing). Thanks again for your insight!

This is why, as a general statement, it is good to keep in touch with our surgeons over the years - annual labs and follow ups if that is their preference (some practices seriously encourage that, others don't). Even though we may be doing fine for several years post-op, occasionally these questions crop up and they are often the best source of info. Our PCP will probably not know how our WLS impacts the question at hand, but often they can call in to your surgeon and get an answer so that both they and we are informed - and the surgeon usually welcomes su*****uiries (strokes his ego to be consulted!) and prevents us from doing something silly based on internet rumors (I saw it on the internet, so it must be true!) Even notionally authoritative sources such as ASMBS usually give only general guidance, and is often 5-10 years behind current clinical practices by virtue of lag in publication of posted guidance and their references.

It's great that you reached out to your surgeon; you have an unusual question, so there really aren't any great answers here. With the mention of NSAIDs, that always brings up a manic discussion, but it is usually focused around pain relief (with the usual stock answer being to OD on Tylenol) which doesn't apply to your problem. Discussing your particular problem (not just your solution of taking Pepto Bismol) with the doctor(s) should yield a better answer as to how appropriate that is, or if there is something better for your needs.

You are absolutely right! So listen up newbies and keep in touch with your doctor and you won't be asking questions like I am down the road. (FYI - they informed me that Gas X was an approved medication that may help with queasiness).

It's easy for contrarians with an axe to grind to say NSAIDS are ok after VSG. And it's easy for doctors, especially those who aren't familiar with VSGs on a daily basis, to say NSAIDS are alright. Some folks get away with it, sure. Maybe even most. But it's a risk not worth taking. The worst happens far too often.

Most of us worry a lot about complications during surgery, or after. But too many are far too complacent long term. I've seen bad things happen too often with NSAIDS. And I've seen too much crappy advice, even from doctors. The risk is not worth it. Not remotely.

Yes!!!

Actually, Grim, it is those surgeons most familiar with the sleeve on a day to day basis that are most amenable to NSAID usage for those procedures, as they, well, are most familiar with those procedures and their patients. The practice that I used had been doing them for some twenty years on a near full time basis (interspersed with the odd bypass here and there) - and that was eight years ago, and there are many others who have been doing so since the 80's and 90's. These are also practice that tend to emphasize long term follow up, so they have a better than average understanding of what their patients are going through over the years; it this was a big problem, they would be doing something about it. (and yes, for their bypass patients, it is no-NSAIDs - because that is what the bypass and its propensity toward marginal ulcers demands.)

I'm sure that you have seen bad things with NSAIDs over the years, as the bypass has been the default WLS for many years, and many have accepted these limitations as just a fact of life in the WLS business. Some have become so scarred from these problems with their bypass patients that they simply transfer their rules to their other patients irrespective the different tolerance characteristics of the procedures. This is one of the factors that has driven some surgeons to move toward developing alternatives that address such long term complications and limitations. That's progress, and it's an ongoing process.

One of the biggest reasons I chose VSG was because I was allowed to take NSAIDS and my bariatric team prescribed me 800 mg Ibuprofen which I use today 2 years out.

It sounds like a sane practice that you found, and is good that you have it prescribed. The NSAIDs are serious medicine and should be treated with respect as they can have side effects even for normal, non-WLS people (and there are some MDs who hold that it was mistake to allow them to be OTC rather than prescribed - a perspective with some merit). They should be used under medical supervision, at least if used consistently.

Eliminating them from a patient's arsenal simply because a doc had a bad experience with a different patient population is bad medicine - akin to requiring women go through a digital rectal exam because men are subject to prostate cancer.

This may be a good question to ask a prospective bariatric surgeon when vetting them - can I take ibuprofin post op? It can provide some good insight into their background and experience.