Taking PPIs like Omeprazole long term and Osteoporosis risk

on 5/28/20 12:25 pm

I had roux en y bypass in 2011. At the time my doctor put me on high strength omeprazole and never took me off. Several years later I just decided to lower the strength, and it worked fine. But I've been on it for 9 years.

Recently I was tested for Bone density and I am nearing osteoporosis, I am heavily into osteopenia territory. I had switched bariatric doctors when I moved out of state. The new doctors have never ever asked me how my bone density is and I'm over 60. I just happened to be going to a new primary care doctor and she is working with me to try to rectify the situation after my gynecologist had me tested ....

This is scary, considering I had super good bone density before my bypass. I am now struggling to get off of the omeprazole and taking even more calcium and vitamin D than I ever have before. My hope is to gain some of my bone density back.

I am curious. What are they Prescribing nowadays? I know it's been a learning curve, are you new patients being told that you will take this forever?

If you are someone who is considering bypass surgery, please do not do this to yourself. It's enough that you will be malabsorptive, but it's not good to take PPIs long-term. This is something to use in the beginning, and as necessary.

on 5/28/20 1:32 pm - Pittsburgh , PA
RNY on 12/19/17

I was just told to take 1500ML of calcium chews everyday for the rest of my life. I use the Bariatric advantage Brand.

HW 299 SW 290 CW 139 GW 140 2/08/2019 OPERATION: Surgical Hernia with excision of total surface area of 55 x 29 cm of abdominal skin.

White Dove
on 5/28/20 1:48 pm

Most surgeons discontinue the PPI after three months. RNY usually stops acid reflux.

Real life begins where your comfort zone ends

on 5/28/20 2:36 pm

Thanks for your reply. I have been taking 1500 mg Calcium, but I recently upped my Vitamin D to 5000 units.

I never had GERD. I was told to take the PPI to prevent ulcers. That's why it was "forever", but now things have changed. That's what I meant about constantly learning. I am wondering what they are telling folks now that many bypass folks have osteoporosis, I read this online, and so I am part of a group of people with this problem.

on 5/29/20 4:20 am - WI

Calcium, Vitamin D, Magnesium, and K2 all work together to keep bones strong.

I take daily for bone health (and the perk that Magnesium helps with constipation...LOL):

1500 mg Calcium Citrate (500 mg three times per day). Calcium Citrate is the best absorbed.

1000 mg Magnesium (500 mg morning and night),

5000 mg Vitamin D,

100 mcg of K2 in the MK-7 form (best absorbed). K2 ensures that the calcium you take is going into your bones and not into your soft tissue. If you are on any blood thinners you will need to check with you doctor before taking K2 since it does effect blood clotting.

Get regular labs done so you can adjust the doses of your vitamins. This is very important. There is such thing as too much vitamin supplementation.

HW 270 SW 236 GW 160 CW 145 (15 pounds below goal!)

VBG Aug. 7, 1986, Revised to RNY Nov. 18, 2010

on 6/16/20 2:03 pm - Beavercreek, OH

I also have osteopenia. I am 9 years out and never took anything for ulcers after my bypass and I've also always been faithful with my vitamins.


on 6/16/20 5:39 pm

Thanks for your reply. I'm sorry to hear you have osteopenia. I hope it doesn't progress to osteoporosis. My guess is that even without an antacid our bodies have problems absorbing the calcium.

After a little over 2 months I have made it off the omeprazole but still take one OTC strength Pepcid at night or I get nauseous. Hoping to slowly wean off of the Pepcid, but at least it doesn't linger in my body all day. I am praying that my body is absorbing some amount more than it was. Time will tell. I will have my bone density scan this fall....

on 5/28/20 2:40 pm
RNY on 02/14/18

I had RNY 2/18 and was never prescribed a PPI. I've never had acid issues pre or post op though. I had significant iron and Vit D issues pre op but now that I'm diligent with my multi, iron and calcium, those numbers have continued to move up. I only have had one bone density scan though so will be watching that for future.

HW: 306 SW: 282 CW:144.8 GW: 145 (reached 2/6/19), next goal - 132.9


on 5/28/20 4:01 pm

Thanks. I thought that might be the case....and the fact that you are doing well gives me hope...I have been weaning off Omeprazole for 2 months and have periodic nausea as I decrease the dose but I am confident I can get off the meds altogether and rebuild my bones.

It was a standard procedure in 2011, not just my surgeon's, but they all prescribed it, and once you're on these drugs longterm, it is hard to get off because your body rebounds and ups the acid. I am following my Primary Care Doctor's advice for slowly lowering the dose. Eventually I will be off of it.

on 5/28/20 6:13 pm
RNY on 06/03/15

we had to take omeprazole for a year, but that was five years ago before all the bad press came out about it. I would imagine my clinic only has them take it for three months or something now.

I don't know why your surgeon had you keep taking it. There are some RNY patients who deal with GERD after surgery, but most do not - in fact, for those who had GERD pre-surgery, it's often vastly improved if not outright cured.

I have osteoporosis, but I'm at "that age" and it runs rampant on both sides of my family. I have no idea if I had it before RNY or not since they never did a baseline. It could have been the surgery - but it could have just as easily been age and genetics. Unfortunately, I'll never know.

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