Bariatric surgery is life changing. Every aspect of your life will likely change with weight loss surgery, even the medications you are and are not allowed to take. Additionally, your vitamin and supplement needs will change with a smaller stomach pouch or sleeve, thus the body’s ability to absorb these will also be altered. All of these changes can be dealt with in a positive manner, resulting in a smaller and happier you.
Roux-en-Y Weight Loss Surgery and Medication
The type of weight loss surgery you choose will have a bearing on which medications, vitamins and minerals are recommended. For those who choose the Roux-en-Y weight loss surgery, food is digested very slowly and only partially absorbed.
Since the Roux-en-Y bypasses the lower portion of the stomach and a considerable part of the small intestine, medications are not easily absorbed and can irritate the pouch and Roux limb. This can also result in marginal ulcers and deficiencies requiring supplementation.
Medication and the Duodenal Switch (DS)
Perhaps the single most successful type of weight loss surgery, the Duodenal Switch leaves the stomach much larger than gastric bypass surgeries, allowing for the consumption of larger meals. With Bariatric support and planning, weight loss patients can supplement their diets with post-operative protein, vitamins and minerals, avoiding deficiencies. However, only physician approved medication should be taken. If problems arise, the intestinal bypass section surgery section is partially reversible.
Gastric Banding, Sleeve Gastrectomy and Vertical Banded Gastroplasty
Weight loss surgeries which restrict food intake while bypassing the bowels (Gastric Banding, Sleeve Gastrectomy and Vertical Banded Gastroplasty) does not typically result in poor food absorption. Therefore, while it may be necessary to take proton pump inhibitors to protect the pouch and decrease reflux, these Bariatric surgery patients aren’t subject to strict supplementation needs. If you choose one of these weight loss surgeries, your Bariatric doctor may prescribe ursodiol (Actigall) to prevent the formation of gallstones.
What are Marginal Ulcers?
Motrin, Advil, Aleve, Celebrex and Excedrin are medications used to treat inflammation as well as fever, headaches and cramps. These non-steroidal anti-inflammatory medications, called NSAIDs, can increase the risk of developing Marginal ulcers between the Roux limb and stomach pouch and should be discontinued after Bariatric surgery.
Speak with your doctor before taking aspirin as he may prefer acetaminophen and opioids for pain relief. While Marginal ulcers are quite uncommon, there are several anti-acid medications your doctor may choose from as a method of prevention. These may be prescribed for up to six months after your Bariatric surgery.
Effectiveness of Medications after Bariatric Surgery
Since your stomach pouch is smaller and the intestine has been shortened, time, delayed and extended release medications may lose their effectiveness. The same is true with anti-depressants and sleeping or nerve medications. Enteric coated (EC) and film coated (FC) medications are also less effective since they do not begin to work until reaching the stomach and small intestine.
Those with high blood pressure, edema and congestive heart failure may be taking diuretics or Lasix prior to weight loss surgery. Unless the doctor says otherwise, these should also be discontinued to prevent dehydration. Blood thinners such as Coumadin are typically stopped prior to weight loss surgery and then resumed gradually, under the doctor’s watchful eye.
If you are taking an oral contraceptive, speak to your primary physician about switching to a barrier contraception to prevent pregnancy. It is important to ask your Bariatric doctor before crushing or cutting any medications in half.
Gastrointestinal Problems after Bariatric Surgery
Mild gastrointestinal problems are not uncommon after weight loss surgery and most often, Imodium AD and Gas-X are chosen as safe and effective treatments. Here’s why:
Diarrhea and Constipation
Smaller amounts of food after Bariatric surgery means smaller stools and a higher risk of constipation. Milk of Magnesium taken once every three or four days is helpful, but the primary way to prevent diarrhea or constipation is to consume plenty of water. Bariatric patients can also benefit from fiber supplements such as Metamucil or Fibercon.
A rapid and significant weight loss after weight loss surgery can lead to gallstones in predisposed patients. The Bariatric doctor can prescribe a medication called Actigall to prevent gallstones from forming.
Weight loss surgery is one of the best things you can do for your body if you are obese, but not without changing your daily intake of vitamins, minerals, supplements and certain medications. After Bariatric surgery, many patients will be able to discontinue previously prescribed medications as physicians find their underlying health issues and daily discomforts are gone.