Confused about NSAIDS

I was on the Ontario board and a question got me thinking. Since most of the people on there are RNY'ers, there is a lot of confusion on whether vsg'ers are also advised against NSAIDS use. I always thought we weren't restricted like they were. It was one of the reasons I choose this surgery. However many are saying the opposite. Can anyone explain what an NSAID is and are we just as vulnerable and have to avoid them forever too? Any input is appreciated. Thanks 

 

 

 

 

This is how my doctor explained it to me. My doctor is conservative, but this was one of the things I like about him.

Sleevers have the same risks of getting a ulcer with NSAIDS as someone that has a normal stomach. BUT when a normal stomach gets a ulcer they have the whole stomach to work with and its a pretty easy to fix even if part of the stomach needs to come out. Our stomachs are so small and more difficult to fix. Depending on where the ulcer is, to fix it they may have to change the procedure to a by pass.
He did say I could use it but to please limit use to maybe once or twice a year. He knows I walk the Susan G Komen 3Day for the Cure (9 years) and I have knee problems. I have decided I will only use them during the walk and only if needed. So during training I will be icing and using tylenol.

That's a good point. Never thought of it that way. So if a NSAID is an antiflammatory, would prednisone for asthmatics be a no no? I seldom need it but I never thought about it before now. 

Our risk for an ulcer is NO higher than those with a big stomach, or non-altered guts.

Here's the issue with NSAID usage, it's not that a pill sits in the stomach, or that we don't have a lot of stomach tissue left. It's that overuse of NSAID destroy the prostaglandin, gastric mucosal etc of the stomach. Taken as directed with food and a PPI usually, there is no greater risk for an ulcer. I've been taking NSAIDS since being about 6 weeks out, and I just cleared my 3 years post-op without any issues. 

http://physrev.physiology.org/content/88/4/1547.full#V._MECHANISMS_OF_NSAID-INDUCED_GASTRIC_DAMAGE

I've been prescribed everything from Aleve to 800mg Ibuprofen after my csection last October.

If a patient is pre-disposed to ulcers, then NSAID usage should be avoided.

There is no reason to avoid them. You'll get varying answers on this one because so many doctors keep the old RNY rules for all patients.

NSAIDS are aspirin, aleve, naproxen, naprosyn, Ibuprofen. There are other by RX only.

 Thanks! I was thinking that many surgeons here, don't perform the sleeve much, and so discrepencies over the two surgeries would cause a lot of confusion. My initial research process confirmed we were not restricted, but they had me worried and I guess, I got easily confused by the term NSAID. I liked the fact that this surgery did not restrict us on any meds, because we never know what the future holds, and what we may need later on.

I feel much better now, and more educated on this issue. 

It depends on what ur surgeon recommends

I think it depends on your surgeon, mine told me no no way find something else like tylenol or a pain patch (joint pain here) I was on salsalate and had to be taken off... Now I just kinda suck it up with the weight loss and my vitamin d levels finally normal my joints dont really bother me as much

Dr Aceves is okay with nsaids occasionally, as long add you protect your sleeve with a ppi. I chose this surgery for that reason, too. Prednisone it's a steroid.

That is comforting news. My asthma has been under control for a while but when it does flare up, prednisone is my life saver. 

I was gonna say... the pain meds he gives us to take home after surgery are NSAIDs... lol.