Hi all,

I'm 6 months bypass post op. I am striving to live as naturally as possible and do not believe that pharmaceuticals are the answer to everything the way the medical industry does. I can't seem to get my team to answer the question - what's the difference between bariatric friendly capsules (such as my multivitamin and the prescriptions they love to write me) and the capsules for other products such natural forms of supplementation? When I look at the inactive ingredient list, they're identical. So why must I take Omeprazole (which has the long term side effect of dementia among others) and not Deglycyrrhizinated Licorice Root Supplement with Aloe Vera (link below)? Last I knew licorice (as in the root not the sugary treat) and aloe don't give you dementia and have studies that show they can prevent and treat ulcers. My team says no to the natural supplements due to the capsules but then say it's ok to take Omeprazole, Colace, and other drugs that are capsules. Since they won't tell me the difference (which makes me suspect there may not actually be one), I was hoping if there is one, someone here could explain. I have a background in medical research, teach evidence based medical practice to medical students, and am a faculty member of a university. I'm very intelligent, have a decent understand of anatomy and this surgery, so please hit me with the science! I love science. I'm good with finding alternatives but I hate it when people tell me what to do but refuse to explain why especially when we are talking about the potential for me to literally lose my mind.

I've been reading this forum and have found it to be a great source of solace. Any help or guidance would be greatly appreciated. Thanks all!!

https://www.amazon.com/dp/B00062IF54/ref=cm_sw_r_apan_i_C2HWJST3NRWAR5661YAE?_encoding=UTF8&psc=1

omeprazole is for stomach acid, its a proven drug. your all natural stuff are typically not recommended by a actual doctor because they are not prescribing stuff like that. I know nothing about the differences in capsules. Some are delayed release like my omprezole. Ive been on ompreazole for a while so had my dad. No dementia. But everything has a possible side affect. I mean you can literally take anything you want. doctors are there to tell you whats best to take per what they know that is scientifically proven, Natural meds and holistic stuff is not their area of expertise... Maybe you can find one of those types of holistic doctors and speak to them

The following is absolutely not advice. Always follow exactly what your surgeon team tells you.

Get blood serum tests every 6 months for vitamin levels. Then eat a vitamin rich diet and move on. You're correct, the American formula of sugar free pop tarts and a fistful of supplements probably isn't the ideally healthy life.

If you don't suffer from GERD or similar there's little reason to continue with PPIs after the 6 month mark.

The difference between bariatric friendly capsules vs the standard type is that bariatric capsules are vegan (made from gelatin) non-bariatric type capsules aren't vegan and made from collagen. Depending on which surgery you choose, for instance, in gastric bypass, the capsule passes through the pouch and straight into the intestine, thereby bypassing the remnant stomach where the stomach acid is produced, and where the capsule would begin digestion.

They prescribe medicines that are FDA approved. Because they're familiar with them because of the studies and probably for liability purposes also. Supplements and natural drugs aren't FDA approved so they steer clear.

I would say that doctors in North America are largely trained in western medicine and western medicine has a large emphasis on pharmaceuticals, of course. You would probably have to find a Naturopathic doctor that is more familiar with natural medicines if you're set on taking natural therapies. Traditional Western doctors just aren't trained in that type of medicine.

Edited April 16, 20224 yr by BypassingMyPhatAss

4 minutes ago, BypassingMyPhatAss said:

the capsule passes through the pouch and straight into the intestine

Bravo, this is precisely correct and absolutely something that needs to be considered. Thank you.

1 minute ago, Pollito said:

Bravo, this is precisely correct and absolutely something that needs to be considered. Thank you.

You're quite welcome!

Thank you guys! I appreciate you all listening and helping. I promise I won't hold anyone to any "medical advice" ?

Just to make sure I'm clear, if I found alternative approaches from pharmaceuticals that came in vegan capsules, those should in theory dissolve in my intestines as opposed to the collagen based capsules which won't?

I have been and do follow my team's orders. I got COVID on month 3 and it has caused me no end of grief. I was totally killing all my goals then after COVID it's been one dang thing after another. First I've got some stomach pain which they think is ulcers but no examination or other labs have determined that for sure. Now I'm severely constipated and have had a fecal impaction. I'm trying to avoid anything with a side effect of constipation, which Omeprazole is one. I'm otherwise following everything they say. I'm just looking for options and I feel like my team isn't really listening to me.

1 hour ago, BypassingMyPhatAss said:

The difference between bariatric friendly capsules vs the standard type is that bariatric capsules are vegan (made from gelatin) non-bariatric type capsules aren't vegan and made from collagen. Depending on which surgery you choose, for instance, in gastric bypass, the capsule passes through the pouch and straight into the intestine, thereby bypassing the remnant stomach where the stomach acid is produced, and where the capsule would begin digestion.

I think doctors are wary of drug interactions between the meds they prescribe & those you self administer. There are enough concerns with the negative interactions with the meds they prescribe without adding natural supplements they don’t know as much about. And many people are guilty of not informing their doctors of everything they take thinking natural supplements/remedies are harmless because they’re ‘natural’. But you can have a bad reaction to anything including naturally derived.

PPIs are usually prescribed for the short term, months, so any potential long term effects would not be a concern. If you were taking the higher dose for years you’d be right to be concerned. Does liquorice root & aloe vera reduce the production of stomach acid (the cause) or do they just soothe the symptoms like over the counter heart burn treatments?

As with all meds you take, it’s best to check where they are absorbed (stomach, intestines) as your surgery may affect their absorption. Many say slow release meds aren’t as successful post surgery.

Hope they sort out the cause of your stomach pain.

short-term use of PPIs is supposedly fine. People used to get on them and stay on them for years and years because it was thought until fairly recently that they were safe. *That* is what is risky. When I had my surgery seven years ago, some surgeons (including mine) kept their patients on the PPIs for the entire first year. Now it's usually 3-6 months.

chronic constipation is an issue for a lot of WLS patients. It's a combination of the high-protein diet and some of the supplements many of us take (namely, calcium and iron). Many people take a capful of Miralax every morning to keep on top of it, but if you're into natural remedies, a few prunes may due the trick.

11 hours ago, Abnormal Angie said:

Just to make sure I'm clear, if I found alternative approaches from pharmaceuticals that came in vegan capsules, those should in theory dissolve in my intestines as opposed to the collagen based capsules which won't?

Correct. That's my understanding. That's the exact reasoning for using gelatin based capsules for bariatric capsulated medications.

Thank you everyone! I really appreciate all the input!

On 4/15/2022 at 10:57 PM, Arabesque said:

Does liquorice root & aloe vera reduce the production of stomach acid (the cause) or do they just soothe the symptoms like over the counter heart burn treatments?

From Healthline https://www.healthline.com/nutrition/stomach-ulcer-remedies#TOC_TITLE_HDR_9 :

Licorice may stimulate the stomach and intestines to produce more mucus, which helps protect the stomach lining. The extra mucus may also help speed up the healing process and help reduce ulcer-related pain.

Researchers further report that certain compounds found in licorice may prevent the growth of H. pylori. However, studies are generally based on the use of these compounds in supplement form. (Why I was looking for a means to take this as a supplement)

...

In one study, aloe vera consumption significantly reduced the amount of stomach acid produced in rats suffering from ulcers.

In another study in rats, aloe vera had ulcer-healing effects comparable to omeprazole, a common anti-ulcer medication.

However, few studies have been done in humans. In one, a concentrated aloe vera drink was used to successfully treat 12 patients with stomach ulcers.

In another study, taking antibiotics with 1.4 mg/pound (3 mg/kg) of aloe vera daily for six weeks was as effective as the conventional treatment at healing ulcers and reducing H. pylori levels.

Thanks for the info about liquorice root & aloe vera @Abnormal Angie.

Remember, though, that just because something is "natural" doesn't mean it is good for you or that it has been carefully evaluated in well-controlled clinical trials. Cyanide is natural, as is uranium, but you don't want to consume either.

There are a zillion drug interactions between pharmaceutical products and "natural" things like grapefruit, Seville oranges, curcumin/turmeric, St. John's wort, black pepper, and so on and so on.

Natural is not always better. Please be careful - and read your prescribing information.

1 minute ago, ardelia said:

Cyanide is natural, as is uranium, but you don't want to consume either

Indeed not! Natural is certainly not always better. But I would say that pharmaceuticals aren't always better either and no, one's doctor does not always know best. If they did, there wouldn't be the overprescription problem that there certainly is in the US, with PPIs being next to opioids in the top 5 most overprescribed drugs.

I had the sleeve over a year ago and I was never even prescribed PPI’s. It’s a doctors preference but if you are worried about taking them I would be asking if you even need anything.