RNY and NO "NSAIDS" ....... Please explain... again..

I am 9 months post op from my RNY and can some of the VETS explain again for the umpteenth time, why is it that we can't take NSAIDS anymore?  I have bad osteo arthritis and I did know that going in, but it is not easy going without my arthritis medicine. I just chose the fact that it will have to be better in the long run for my body to have 100 lbs less to carry around!  If we took it with food, how is it still dangerous?  ALso, what happens to the other part of our stomachs after the pouch is formed and sectioned off?  Just sometimes wonder about these things.... Thanks as always....

Taking NSAIDS with food will not change anything, nor does taking it in a non-oral form (e.g., IV).   It is not a bit safer with food than without.  The only thing that MAY lessen the chance of ulcers is to take a PPI along with the NSAID to try to protect your stomach (it is still no guarantee that you won't get an ulcer, though).

The problem with NSAIDS after RNY is that NSAIDs have a systemic effect (it has nothing to do with the pills being in your pouch) that causes the lining of the stomach and pouch to thin, opening you up to the potential for ulcers both places.  Getting an ulcer either place is painful, but NSAIDs are more of a problem for RNYers than those with sleeve or DS because we can get ulcers in our blind remnant stomach (which can only be reached by surgery and therefore can be very difficult to treat).

Your remnant stomach just sits there and continues to generate digestive "juices" that get released into the intestine.

Lora

My surgeon has allowed his patients to take Nsaids once we are a year out from surgery. He insists we take it on a full stomach, or at least with food-yogurt, protein, something to help it while in the stomach. He and many others have reversed their "no nsaids" approach since gel caps came out - the gel form seems to be better for us. My doc has us take it with food, for short periods and with no history of ulcer. I had an ulcer years ago and once healed, can take them again when needed:sports injury, dental work, etc. I've never had a problem, I and many other post ops take them responsibly without any side effects, ulcers or other complications. Many need the anti inflammation properties of an nsaid and for many it's a life saver. check again with your doc or rhumatologist or arthritis doc. Many of us take them, discontinue if we have any pain after ingesting them. I've taken Advil when needed for 10+ yrs now, with no problems. (my ulcer was not related to nsaid use). If you have chronic pain issues your doc can set up a schedule for taking them that works with your new digestion and give you guidelines to watch for in case you have pain, ulcer symptoms or other problems. I can't do without my advil when I have inflammation (I have a broken finger right now), and Tylenol messes with our livers so much, many opt not to take that either. check with your doc but for many of us Advil is an ok alternative and we don't have any problems.We find out post op what works for us - and if we need something we can work it into our new lifestyle to help us move along.

Jen 11+ yrs post op RNY

Unfortunately, many doctors don't seem to know how NSAIDs work (and that baffles me).

I would ask your doctor how taking it with food negates the systemic effect.  It is the systemic thinning of the stomach and pouch lining that makes them unsuitable for us, not because they might damage the pouch during the very brief period of time that they are in the pouch.  (How would NSAIDs in the pouch cause ulcers in the remnant stomach if that was the issue?)  If that was the problem, we could just take them with a half glass of water, which would completely and immediately wash the pill out of the pouch and well into the intestine and there wouldn't be a problem at all.

I'm not trying to sound snarky, but I would also ask your doctor how he would treat an ulcer in your remnant stomach (which is only accessible via surgery) if you develop one from taking Advil.  At least then you will be giving full informed consent when you take NSAIDs.

Lora

I just had RNY on June 17th and my surgeon removed my remnant stomach.  I don't know anything about NSAIDS so can't help you there.