Question for WLS Grads - PPI and Calcium Malabsorption?

Just wondering if your doctor put you on Protonix, Prevacid or other PPI after surgery?  My doctor put me on Protonix says he puts all his patients on it for life. My sister and brother both had RNY by a very esteemed doc (Dr. Brader) and neither were put on a PPI.   Read an article today posted about Small Intestine Bacterial Overgrowth in RNY patients that leads to Calcium/Zinc Malabsorption and it mentions the lack of acid being a cause of the overpopulation. Wondering if you have Calcium or Zinc Malabsorption issues if you also are on a PPI? Just me....trying to get ahead of anything that could go wrong....

I was only put on prevacid when I developed an ulcer more than a year after my surgery and I only took it until it healed and then I stopped taking it.  I guess I don't really understand why your doctor would put you on a PPI for life after gastric bypass.  PPI's basically just help to reduce acid in the stomach but in your new pouch you don't have stomach acid..or you have very little.  All your stomach acid should still be in your "old" stomach.  I had severe acid reflux before surgery and within days after my surgery it was gone because there was no acid to come up anymore.  Anyways, it just doesn't make a lot of a sense to me as to why he would put all of his patients on that for life.   As for the calcium malabsorption issue, yes PPI's can cause calcium malabsorption because they reduce the amount of hydrocholoric acid which is needed to absorb calcium.  However, as a gastric bypass patient you should be taking calcium citrate which doesn't require the stomach acid to be absorbed so in all reality even if you are on the PPI's you shouldn't be malabsorbing calcium because of that if you are taking the calcium citrate. Hope that answers some of your questions..

Kerri

I too am on Previcid I just started..am intrested in the answer to this. Cha

I was put on Prevacid the first 3mths after surgery and then was told I could discontinue using it. Haven't had any problems up to this point.

I read this article, too and let me scratching my head. I've read about the potential for bacterial overgrowth because there is no acid being washed thru the intestine.

As for malabsorption of vites and minerals.... that's what happens with ANY WLS, except bands, who just can't eat enough.

so how valid is thisassumption if we don't know how much of what the subjects were taking and with what/whom were they compared? Since some ppl take PPI's, some dont', but everyone has some issues with malabsorption, is this study even valid for us?

YES!  YES!   YES!! I've had SBBO several times.  I take probiotics every day and I have still ended up with SBBO (after/during a bowel obstruction which makes sense that colon bacteria gets up into the small intestine as the bowel is backing up).  I HIGHLY SUSPECT that the "gas" that is reported by RNYers after the six month mark (typically when they introduce carbs more) is from SBBO.  Usually, the body can and will correct itself; however, some of us aren't so fortunate and require treatment more so than probiotics.  Without question, PPIs affect bacterial growth.  PERIOD.  That "affect" may be so minimal that's it's unnoticed especially in a person who naturally maintains and/or quickly corrects an overgrowth.  However, I believe that some people are more predisposed to bacterial overgrowth issues than others - just as many things are -- in the genes -- a product of your environment or diet.  I'm suspicious that IBS, colitis, chron's etc. are all about bacterial imbalaces.  I'd love to see more research on this.  The bacteria will cause one to crave MORE of whats it digests in order to survive which further complicates things for the "host" or person.  So much of our heath comes from the digestive tract that it's not difficult to believe, assume, and/or prove (I suspect) that bacterial overgrowth is cause for many ailments as the immune system is generated here, toxins are fought here, etc.  "You are what you eat."   Wasn't it Hippocrates who believed in the secret of being diagnosed and/or of maintaining good health could be discovered through the 4 types of bile?  I believe he was RIGHT ON.  We made a HUGE mistake when we abdondoned that premise - as well as when we created other strains of bacteria in capsules to ward off other forms of bacteria.  I won't dismiss antibiotics as being life saving and even necessary; they are, however, overused causing a lack of tolerance and squashing/minimizing the body's ability to ward off disease and illness BEFORE and after it occurs. I could go on and on and on about SBBO but to more directly answer the question posed, "Not only do I believe that (thought I'm not sure which study this person read) studies on SBBO are relevent to us, I believe they are MORE relevent to us than to a non-RNYer.