Question:
Absorbtion of medications and info on ani inflammatory drugs

I have read several places that after gastric Bypass the medication we take, we get half the effect as we would have BEFORE the bypass surgery. What is the truth in this fact? Also I have read that anti inflammatory medications are NOT recommended as the cause internal intestinal bleeding in Gastric Bypass patients. Lord knows we sure don't need added problems! If any one has some definative facts on these, please let me know so that I may pass htem on to the doctors I am surrently seeing, who have no ideal on how to deal with Gastic Bypass persons after surgery. Thanks    — leahrobinson (posted on January 24, 2006)

January 23, 2006
Leah, We don't absorb anything the way we did before surgery so yes medication are included in this list as well. If your on an Extended release medication it may not do anything for you after surgery. However I metabolize medication differently now, pain medication hit me harder then they did before and knock me on my but. I don't think this is just the weight loss either. As for Ibuprofen and NSAIDS (Aleeve, Naproxen etc.) You are not supposed to use them since the upper stomach does not make any gastric juices so it has full blown ability to eat at the stomach lining of your new pouch. In addition medically you should not have a blind nasogastric tube inserted because it can puncture your small pouch. I hope this answers some of your questions. Denise
   — dlryanoates

January 23, 2006
Leah, every time this comes up, I ask for someone to please site some specific studies and no one can site any stating that NSAIDS will "eat" the lining of the pouch. It comes from the infamous "they". While some people have problems with absorbing extended release medications, it seems to be a very indiviudal thing; I have no problem taking an extended release medication. I don't believe there are studies out there that have measured how much of any medication is actually absorbed, post op. At three years+ out from surgery, I also take ibuprofen for headaches and other muscular aches and pains without any ill effects. I am of the opinion that any medication used with caution is worth a try. As you get farther out post op, you will find there are no "hard and fast" rules, and how you respond to meds may be a very individual thing.
   — koogy

January 23, 2006
Hey Leah, I have to disagree with Deniese, her words sounded good, but she didn't reference anything that she said....this is how old wives tales get started... So let me start....We had a group meeting last month, in Houston, where our speaker was Dr Vorit Wongsa...and some of the sames questions came out, in very direct manner...and he answered them in very direct manner... Antibiotics...Do we mal-absorb them?...Dr Said..."I have not seen any evidence in my readings or practice to indicate that wls patients mal-absorb antibiotics to any level that would require, adjusting the medication levels... Nsaids.....Doctor said..."If you have had trouble with Nsaids before surgery, you will have problems after surgery...other wise you will be ok"...(personally my doctor prescribed Liquid motrin on my first day after surgery...my doctor prescribed it....how much more do you wanna bust that myth?).... Asprine therapy, The doctor said..."the problem with asprines is not that it "eats a hole in your stomach...the problem is that it has a vaso dilation effect...and that if you take a couple of asprines and they sit in one spot on your stomach...because you didn't drink enough water...they will cause the vessels to dilate and may cause bleeding.... But he said...In the case of baby asprine therapy...the dose is very small, and that the benifits outweigh the risks...he suggested takeing the baby asprine.... If you would like to verify what I have said, Dr Wongsa's phone number is in the surgeons listing...and my surgeon, dr Carlos Ferrari is listed there too..... This is what I have heard from a Surgeons mouth...in front of witness' Call around in your area, and look for another doctor to follow your progress....or at least get in a doctor mediated support group hope this helps Russ
   — [Deactivated Member]

January 24, 2006
I believe all the answers you have received are correct and incorrect.......lol. All of the problems associated with malabsorbption can and do affect some, but not all. My surgeon told me they have seen very little evidence that thyroid meds need adjusting due to the surgery and so far (7 weeks) my bloodwork indicates my meds are working just fine. As far as NSAIDs go, I am avoiding them. I have known people who "had no problems" and then found they had ulcers, so why take the chance if I don't need to? Tylenol with codeine works for me for severe pain and if it doesn't, it usually means it is sinus related so I take pheudophedrine and benedryl with the acetaminophen. I do, however, take the 81mg aspirin for my heart. To "deal with gastric bypass patients" your Drs need to have labs done on a regular basis to monitor you. It is done more often the first year. Although the surgery may be the same for many, the way our bodies respond can vary.
   — LauraA

January 24, 2006
Depends on the med. I still take original doses of some meds, others are altered to fit. I try to avoid timed release, not because they will hurt me, but with my altered system, there is no certainty that I will get all the meds intended. The info on NSAIDS is part of the warning that comes with them. I was one who was fried with Ibuprofen and erythromycin BEFORE surgery, so I learned what NSAIDS were long ago, and thru the back door, so to speak. FIRST I got the ulcers, THEN I found out why. However, you can certainly look up a few by name and find the info right in the warnings. I believe a few papers have been presented on them at ASBS, as well. Didn't pay a lot of attention, since I was already a believer by the mid-80's! The info is out there. If you go to any group of long term post-ops, you will find those who didn't believe this and have had recurring ulcers or gastric bleeds as a result. But of course, that's just anecdotal info.
   — vitalady

February 20, 2006
I month out and here is my answer. I take Mobic, an anti-inflammatory, to help with the severe arthritis I had in my knees and back and hips, but I also take Protonix or Prevacid to help alleviate any stomach problems from the Mobic. I do take Effexor time release and Neurontin time release and they seem to be working well. I take other meds, the same ones I took before gastric bypass. Everything seems to be work, and I also take vitamins, not necessarily chewable. They work for me.
   — KRWaters