Why is my PPI not working?

[hellohalo 2]

Hi guys,

It's me again. I'm 6 days post op and I'm realizing more and more that my symptoms are reflux. I take 40 mg of pantoprazol every morning since the day after the surgery yet I cough like crazy, have food stuck in my throat feeling and almost feel the acid bubbles circulating. Not to mention the crazy hunger feeling I get even right after eating. Are these symptoms normal the first weeks of sleeve? Or is it really possible to get reflux this early stage while on a high dose of ppi? I'm not looking forward to eating real food!

[KimA-GA 540]

Did you have reflux before?

did you have a hiatal hernia ?

[RickM 1,747]

I wouldn't say normal, but not all that unusual, either. It is normal for acid production to go into overdrive after a stressful even like a surgery - I was put on pantoprozole twice a day for a month after a minor cardiac procedure earlier this year for just that reason. Add in the trauma to your stomach and the potential inflammation, etc., and it's not unreasonable for it to happen. A twice a day dosing wouldn't be unusual, either, so talk to your surgeon's team about that. Also, the acid is said to mimic, hunger, so that is also consistent.

[hellohalo 2]

39 minutes ago, KimA-GA said:

Did you have reflux before?

did you have a hiatal hernia ?

I would get reflux sometimes after a heavy meal or if I ate too close to bed. I think I don't have hiatal hernia or else my surgeon would have mentioned it after the surgery

[hellohalo 2]

11 minutes ago, RickM said:

I wouldn't say normal, but not all that unusual, either. It is normal for acid production to go into overdrive after a stressful even like a surgery - I was put on pantoprozole twice a day for a month after a minor cardiac procedure earlier this year for just that reason. Add in the trauma to your stomach and the potential inflammation, etc., and it's not unreasonable for it to happen. A twice a day dosing wouldn't be unusual, either, so talk to your surgeon's team about that. Also, the acid is said to mimic, hunger, so that is also consistent.

Thank you so much for your reply! My appointment is 1 month later, so until that I think I just have to follow my symptoms and keep an eye on it but definitely will ask about the dosing

[RickM 1,747]

1 hour ago, hellohalo said:

Thank you so much for your reply! My appointment is 1 month later, so until that I think I just have to follow my symptoms and keep an eye on it but definitely will ask about the dosing

If it's significant enough that you are bringing it up here, then it is enough that you should call them on it and not wait. Beyond unpleasant, it can cause damage if left un/under treated. And yes, it is unlikely to be a hiatal hernia, as while common pre-op, they are commonly fixed during the surgery, sometimes without comment.

[liveaboard15 1,292]

Guessing you had the sleeve? Typically those with heartburn history are told to get bypass instead. but i had the sleeve and the acid reflux was bad for the first couple weeks. even with that same medication you are taking i was taking. but it eventually got better and have not had it since. I hope that is the case for you because the reflux was so painful a couple weeks after surgery that it was driving me crazy

[Tomo 1,141]

Takes a while for pantoprazole to kick in, sometimes as long as 3 to 4 weeks. I had the sleeve back in 2015 and I never had those symptoms in the beginning. I would call your surgeon. Maybe they can switch you to Omeprazole or another type of medication that will work better for your body. Fast forward, a few years, when I first started getting gerd symptoms, I was put on famotidine and when that stopped working, I was switched to Omeprazole and then to a few others.

[hellohalo 2]

3 hours ago, liveaboard15 said:

Guessing you had the sleeve? Typically those with heartburn history are told to get bypass instead. but i had the sleeve and the acid reflux was bad for the first couple weeks. even with that same medication you are taking i was taking. but it eventually got better and have not had it since. I hope that is the case for you because the reflux was so painful a couple weeks after surgery that it was driving me crazy

Yes, I got sleeve. Bypass was not much of an option for me and my reflux before surgery was pretty manageable so I thought it was worth the risk. My sister works at a bariatric clinic, she told me the first month acid reflux was normal but I'm very hesitant when there are a lot of people who don't experience it at all. I hope mine goes away like yours too!

[hellohalo 2]

2 hours ago, Tomo said:

Takes a while for pantoprazole to kick in, sometimes as long as 3 to 4 weeks. I had the sleeve back in 2015 and I never had those symptoms in the beginning. I would call your surgeon. Maybe they can switch you to Omeprazole or another type of medication that will work better for your body. Fast forward, a few years, when I first started getting gerd symptoms, I was put on famotidine and when that stopped working, I was switched to Omeprazole and then to a few others.

The Dutch healthcare system is very straightforward when it comes to medication. I'm pretty sure and unfortunately they will dismiss my concerns the first 6 weeks if I'm able to keep food and Water down and tell me to wait and let the stomach heal

[Nomoredebbiecakes 0]

2 days post op gastric bypass with hiatal hernia repair and I feel awful