NSAIDS post RNY question

You're welcome, Dave! I just emailed you the info regarding the pdf in case you hadn't seen it yet (http://www.soard.org/). Great minds, eh? Or is it too-much-free-time minds? As far as memory loss goes, I'm at that age where I experience so-called "normal" lapses, slowwwwww recall of words, etc. So I'll never know if I have a memory loss! Er, what was I talking about?

PPIs like Prilosec or Nexium (or Prevacid) are remarkably well tolerated. In fact, it was their lack of serious side effects that led to the FDA to switch Prilosec from Rx to OTC status.

It is true, esp. theoretically, that PPIs can reduce calcium and iron absorption by reducing acid production in the stomach. However, post-op RNYers already have lower than normal acid production in the pouch, plus we are instructed to use calcium citrate as a calcium supplement , since it does not require stomach acid to be absorbed.

As for memory loss, I don't recal ever coming across that side effect!

/Steve

Hey Dave... it depends...and that is the best answer you can get...my doc perscribed liquid Ibuprofen on day 2 post surgery...and they handed it to me in the hosptial....so it depends....(that is my weapon of choice)

Wow, Russ

NSAIDs prescribed from the start. Doesn't seem to fit anything I've read about the meds and those who have had gastro-intestinal surgery. My doc said one baby aspirin a day shouldn't cause any problem, but wouldn't speculate on anything more than that.

I've quit taking that since my bloodwork shows I'm virtually 0 risk for anything related to arterial plaque buildup (LDL bad cholesterol is too low in relation to HDL and total is 148). I was also worried that the flax oil I'm taking in combination with the aspirin might cause bleeding.

Hopefully by the time I get joint pain they'll have invented something totally new and safe.

Best Wishes,

Dave

I split it up during the day.  I take my NSAID and Prilosec in the morning, calcium throughout the day, and iron at night.  My labs are basically perfect.  It would also be worth noting that I used to take 3 doses of my NSAID a day before WLS.  That was what I was subscribed.  Since my RNY, I only take one dose which happens to be the smallest effective dose.   So far, so good, a little pain in my knee if I overdo it.  Like today, I took a long walk on the beach this morning and then hit the eliptical machine this afternoon at the gym.  Not good but I'll live.  Feeling it now after sitting in the theater watching Han**** for the past 1.5 hours.  I know that someday I'll have to have knee surgery, but I'll put that off as long as possible Again, I would strictly follow my own surgeons protocol. John

I have Rheumatoid Arthritis so I basically live on pain meds. My surgeon told me to take 1 prescription Prolosec a day and take my prescription NSAID 3 times per day.

Dave, Dam! Sorry  about your injury and the ongoing pain. I’d give the doc a call and ask about A combo prescription of an NSAID with Nexium. I have a torn rotator cuff That acts up about 1 week out of every 4 or 5. Feels like someone hammered a rusty fork in my joint And they give it a couple of twists every time I move it. The Meloxicam/Nexium combo works really well. I’ve been taking it (for 8 to 10 day stretches) For over 2 years. No problems what-so-ever. I’ve tried every thing from electro stimulus, to massage and physical therapy, but it looks like it is eventually Going to take surgery to repair. I’m just putting it off for as long as I can. However, for other pains and such, Physical Therapists have done marvelous miracles For me in the past. Perhaps check out if they can set up a course of therapy for you And in the meantime, get your doc to give you something To knock the edge off the pain. Hope you get some relief! Best Wishes- Dx

NOT FOR ME!!! After 2 bad gibleeds, the docs at my Hospital finally realized that as I'd taken like 6 x 200 mg Ibuprophens, that I'd caused those bleeds myself! Solid pills or caplets (at least in everything I've read and specially for my body)  tend to get "lodged" into a pocket after they slide thru my pouch...and they burn the sidewall of my small intestine whih caused gibleeding...big time! Those caps are small and go right thru my pouch.... Plus those dang scopes in BOTH ends....I learned my lesson quickly. Course, nothing alleviates my pain for joints etc better than ibus, so I now take GELS only which melt quite quickly.... I'd surely ask my  pcp for more advice on this.... Jim

Yep, many NSAIDs can work in two ways to irritate the pouch.  First is their systemic effect in reducing prostaglandin synthesis, and the resulting decrease in protective mucus.  The second stems from the fact that some NSAIDs (such as ibuprofen, aspirin, naproxen and many others) aren't very potent: a therapeutic dose ranges from 500mg to 2 grams (6x200mg ibuprofen is 1.2 grams of drug), and most of these are organic acids themselves, so they have a direct contact irritant effect on the lining of the pouch and intestines (especially if they get "stuck") as well as a systemic effect.  Liquid or gelcap formulations help avoid this but don't completely eliminate the risk. Some Rx-only NSAIDs are much more potent than the ones mentioned above, meaning that a smaller amount of drug is effective, such that their direct irritant effects on the GI lining due to their acidity is minimal.  The NSAID Relafen (nabumetone) isn't an organic acid, but is later metabolized to the active organic acid by the liver, so it has no direct irritant effects when swallowed. /Steve /Steve

foobear....are you indicating that there may be "other" ways to get rid of joint pain etc that are as good as Ibu but don't carry the same cautions... if so, great! what might the drug's name, ie what can I ask my pcp about for more info? :-) Jim