I was prescribed Pantoprazole before surgery (after my endoscopy) and after my VSG for 30 days.

I was advised I will probably not need it 30 days after my VSG but I beg to differ. I forgot to take it one day before work and boy did I feel the acid bubbling.

Any suggestions on the best OTC acid blockers - just in case they do not refill my prescription - just thinking ahead.

Thanks

I was prescribed pantoprazole for 30 days after surgery as well. They would not refill that script even tho i requested it. But i have not had any heart burn since tho a few weeks after surgery it was strong. My primary doctor gives me a script for Omeprazole. Which is available over the counter at any store but its much cheaper with a prescription.

I take Omeprazole (Prilosec) and I know there's Esomeprazole (Nexium). I don't know about any others, but I know those work well.

Pantoprozole (Protonix) is also available OtC. Depending upon insurance details, OTC may or may not be cheaper than Rx - OTC omeprazole is usually around $15 at Costco for 42, sometimes on sale for a few bucks less. Use the one that works best for you. Also try Pepcid, which is an H2 inhibitor and is generally considered friendlier to our systems long term than PPIs such as the -azole meds above. The PPIs are also known to have a problem with rebound reflux if you stop them suddenly, so it is usually better to wean off of them over a couple of weeks - cut the dosage in half or spread the dose timing, or intersperse a dose of PPI with one of H2I. Some may never have a problem with dropping them, but if one does, try tapering off the med.

Don’t know if it is the same in the US but in Australia you can only get 10mg over the counter and need a script for a higher dose. You may need 20g as 10g usually is enough to manage symptoms like general heartburn not reflux/gerd symptoms. But it will depend on the severity of your symptoms.

Esomeprazole is considered better than omeprazole. More advanced formulation that has fewer side effects apparently. Short term usage (months) shouldn’t cause any issues regardless.

What does this all mean? I thought acid reflux is very rare after VSG? Is that not the case? This is my 4th day post op and I have to take omeprazole for 30 days.


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1 hour ago, Supafly82 said:

What does this all mean? I thought acid reflux is very rare after VSG? Is that not the case? This is my 4th day post op and I have to take omeprazole for 30 days.


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The VSG is somewhat predisposed to reflux, meaning that a greater proportion of those with that surgery will have that problem than the general population. The sleeve reduces the volume of the stomach much more than its' acid producing potential, and sometimes the body doesn't fully adjust to that. The bypass in comparison is predisposed to dumping syndrome, reactive hypoglycemia, marginal ulcers and mineral deficiency disease, so there are trade offs with whatever route one chooses (and with doing nothing, given all of the obesity related diseases that we are trying to avoid!)

This is not unusual when we change things in our body - surgery of any kind changes things and sometimes there are negative aspects, or risks of, along with the positives. Medications change our body chemistry to solve a problem, but sometimes there are side effects that are negatives.

It is routine for patients to be given a PPI for a while after any WLS, or even on GI procedures - I was put on pantoprozole for a month after a minor cardiac procedure I had a few months ago simply because when the body is under stress (like form surgery) it tends to over produce acid. So, being on a PPI at this point is normal, and nothing to worry about.

10 hours ago, Arabesque said:

Don’t know if it is the same in the US but in Australia you can only get 10mg over the counter and need a script for a higher dose. You may need 20g as 10g usually is enough to manage symptoms like general heartburn not reflux/gerd symptoms. But it will depend on the severity of your symptoms.

Esomeprazole is considered better than omeprazole. More advanced formulation that has fewer side effects apparently. Short term usage (months) shouldn’t cause any issues regardless.

20mg is the standard OTC dose in the US for omeprazole.

Esomeprozole (Nexium) was more advanced in that it was a minimum change from omeprazole in order to establish a new patent when omeprazole (Prilosec) lost patent protection and they moved it to OTC. Physicians were hounded by the drug reps to change their patients Prilosec Rx over to Nexium, and there was a major marketing campaign to the public to establish demand for the new pretty "Purple Pill." Doctors who were overly aggressive in switching their patients were often chastised by their peers for "caving in" to the Pharma marketing push. The general advice then, as now, is that if there isn't any side effects noted with the older med, there was (is) no compelling reason to go with the newer, more expensive med. Pantoprazole (Protonix) was a different med in the same class by a different manufacturer that did have notably different characteristics that were often useful (ie, "better") but again, if the older, cheaper med works without problems, that's fine.