Ibuprofen use and ulcers

[VDB 800]

Close to two years out. Just had another big blood test and all is normal again. Diabetes almost done, edema almost gone, mobility and balance are back, high blood pressure 100% gone, huge overall health benefits! I have not lost as much as desired, but since I have not been this light since 15 years old (66 now), I am not complaining.

My question is around pain relievers. Working a small farm, sometimes I can get a bit hurt. I need an anti-inflammatory like ibuprofen, but my bariatric PA says never again due to the danger of ulcers. She would like me to be on a proton inhibitor long term to protect against ulcers, but my regular MD does not think so due to long term side effects. She also says that ulcers are very dangerous for gastric bypass patients, and that I will get them if I use ibuprofen. Tylenol is all that I can use, and don't use it because it does zero for me. Zero!

Anyone dealing with this? Any good advice?

[Berry78 4,259]

Do NOT go against the recommendation against nsaids.

There are other modes of getting pain relief.. Patches on the skin, or maybe types that are absorbed under the tongue.

Your doc can prescribe pain meds that would work better than tylenol for specific injuries.

Good luck!

[James Marusek 5,244]

Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

So avoiding NSAIDs is important to prevent ulcers. NSAIDs include Aspirin, Ibuprofen, Diclofenac, Naproxen, Meloxicam, Celecoxib, Indomethacin, Ketorolac, Ketoprofen, Nimesulide, Piroxicam, Etoricoxib, Mefenamic acid, Carprofen, Aspirin/paracetamol/caffeine, Etodolac, Loxoprofen, Nabumetone, Flurbiprofen, Salicylic acid, Aceclofenac, Sulindac, Phenylbutazone, Dexketoprofen, Lornoxicam, Tenoxicam, Diflunisal, Diclofenac/Misoprostol, Flunixin, Benzydamine, Valdecoxib, Oxaprozin, Nepafenac, Etofenamate, Ethenzamide, Naproxen sodium, Dexibuprofen, Diclofenac sodium, Bromfenac, Diclofenac potassium, Fenoprofen, Tolfenamic acid, Tolmetin, Tiaprofenic acid, Lumiracoxib, Phenazone, Salsalate, Felbinac, Hydrocodone/ibuprofen, Fenbufen.

[VDB 800]

Thanks JM, you are always helpful. This really helps. I am going to focus on injury avoidance (being in even better shape).....and no NSAIDS....

[Diva Taunia 198]

As someone who decided to ignore the doctor's advice and take NSAIDS and ended up with ulcers: please, please, please: follow your doctor's advice. Even if you think it's worth it to take it just a couple times to alleviate the pain: IT'S NOT.

I totally understand not taking Tylenol: it doesn't do a thing for me either. The problem is avoiding opiates, obviously. There are other pain relievers that you can take and it's best to have a serious discussion with your doctor if you have chronic pain that needs to be managed.

My doctor prescribes Tramadol (Ultram) for me for migraines/cramps/severe pain. It's the only thing that works for me. I know this tends to be a solution for a lot of weight loss surgery patients because it's easier on the pouch, but you have to be very careful because it's a low-level narcotic. I take it only when needed and it has been a good solution for me.

[VDB 800]

Thanks Diva -- great advice. I will check on Tramadol with my MD.

[Diva Taunia 198]

You're welcome. Good luck!