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Prilosec

PPI Gastric Bypass Complications prilosec ask dr. callery

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#1 Jaclyn78

Jaclyn78

    Member

  • Members
  • PipPip
  • 27 posts
  • LocationFlorida
  • Age:34
  • Surgeon:Dr. Ben David
  • Hospital:Shands
  • Height (ft-in):5-02
  • Start Weight:252
  • Current Weight:149
  • Goal Weight:135
  • Body Mass Index (BMI):27
  • Surgery Date:01/18/2012
  • Surgery Type:Gastric Bypass

Posted 13 February 2012 - 10:43 AM

What is the significance of taking Prilosec daily? I have never in my life had heartburn and was advised to take Prilosec for at least a year or longer. Just curious why.


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#2 Dr. Callery

Dr. Callery

    Bariatric Surgeon

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Posted 23 February 2012 - 08:35 AM

What is the significance of taking Prilosec daily? I have never in my life had heartburn and was advised to take Prilosec for at least a year or longer. Just curious why.


Dear Jaclyn,

Many surgeons ask patients to take an acid blocker for a while after gastric bypass to allow the gastrojejunostomy to heal completely. We found that if we asked patients to use omeprazole for 3 months after surgery we nearly eliminated early anastomotic ulcers. There's no research that I'm aware of that is published on if or how long to prescribe acid blockers. I'll bet there is a range from surgeon to surgeon from none at all to a year.

There are some risks of using PPIs for prolonged periods of time. These can include difficulty absorbing magnesium and calcium (risk of fractures), increasing the risk of the development of a toxic colon bacteria, c. difficile, and other bacterial overgrowth conditions. PPIs do not increase the risk of cardiac conditions or cancers. PPIs like any other potent medication should be taken for the shortest period of time necessary. If you are going to use them for more that a few weeks, you should consult with your primary care doctor regarding drug interactions and other health implications. If you have been on higher doses of PPIs it is good to taper the dose since rebound elevated acid levels can occur with abrupt withdrawal. An example of a taper would be from twice daily dosing to daily dosing to every other day dosing taking two weeks for each step. An H2 blocker such as Pepcid can be used after the PPI is stopped for a couple of weeks.

Talk with your surgeon and find out why he wants you to be on PPIs for a year, ask him about complications and drug interactions, and speak to him about a taper. Also, ask him if his recommendation is evidence based or if it a matter of his practical experience. (Note, we docs often have to make decisions based on practical experience. Research takes years and we have to do what we think is best for our patients until it is published.) Please feel free to post his comments, and I'll include them in this thread.
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This advice is not a substitute for a consultation with your doctor, nutritionist, or other healthcare professional.
As always, if you have a problem or health-related complication (or emergency), please contact the proper authorities immediately.