Bariatric surgery is a significant event in your weight loss journey.  This is not an easy decision because it requires months of hard work and dedication to have optimal health before surgery is authorized.  Your struggle with obesity is personal and is a lifelong chronic disease that is not cured through weight loss surgery.  No amount of dieting, medications, or weight loss surgery can cure your obesity; only through hard work and dedication to your health can your obesity be put into remission.

To promote a healthy life after bariatric surgery, there are many health requirements your physicians recommend you follow to ensure you have optimal healing after surgery.  One primary requirement after surgery is to stop taking any Aspirin-like medications to reduce pain.  Nonsteroidal anti-inflammatory drugs ( NSAIDs) significantly irritate the stomach and can cause severe health issues that typically result in an ulcer.

Medication Changes after Surgery

Your prescriptions and over-the-counter drugs are absorbed differently after your bariatric surgery because of the changes to your stomach and overall digestion system.  Immediately after surgery, you will have to take smaller capsules because larger pills can become stuck.  You may be required to take crushed, liquid, chewable, sublingual, or injectable pill forms after surgery. Your surgeon will need to explain how certain medications need to be taken for the best outcome.

Your medications have a higher likelihood of needing to change after surgery, but this is not absolute.  Your doses may change or decrease as your obesity-related conditions improve.  An example is a diabetic bariatric patient will need less insulin or other diabetic medications after surgery because their glucose control has improved significantly after surgery.

Other improvements to your medications are lowering your doses of high blood pressure medication or cholesterol medication due to improved health after surgery.

Medications to Avoid after Surgery

There are specific medications you need to avoid after bariatric surgery. One particular group of medications you will not be able to take after bariatric surgery are NSAIDs.  NSAIDs are commonly labeled, Aspirin, Ibuprofen (Advil and Motrin) Naproxen (Naprosyn and Aleve), and Celebrex.  All of these medications increase your risk of developing ulcers because they cause stomach irritations.  

Ulcers are not typically fatal, but they are challenging to diagnose and treat after bariatric surgery. They often occur at the connection of gastric pouch and small intestine, also called marginal ulcers. It can cause months and years of discomfort. They can cause significant pain, bleeding, chronic anemia, or acute blood loss, and they can perforate, causing severe infection in the abdomen. Any of that may require an operation, sometimes even reversal of gastric bypass.

The main reason NSAIDS is prohibited is that these oral medications leave your stomach lining more vulnerable to its acid. When you take medications that are already acidic, you are causing more irritation to your stomach lining, which is incredibly sensitive and vulnerable after gastric bypass surgery.

You should not take Aspirin or Aspirin containing products for one month unless your bariatrician tells you differently.

After one month, if you must take an Aspirin, you need to take a daily antacid to protect your stomach.

What Causes Inflammation in your Stomach?

There are specific effects of NSAIDS on your stomach after gastric bypass.  After surgery, your stomach produces prostaglandins, which protect your stomach lining from acid by reducing inflammation.  Stomach acid helps you digest your food while you eat, but this acid is harmful to the lining of your stomach.  Prostaglandins naturally protect your stomach lining from your stomach acid.

When you take an NSAID, you strip away your body’s natural protection mechanism, which are prostaglandins.  You are no longer able to protect your stomach lining from its stomach acid, which leads to increased stomach irritation, which is dangerous after gastric bypass.  This is dangerous because, after gastric bypass, you are at a high risk of developing ulcers.

All of these health requirements do not only apply to orally taken NSAIDs.  You are not advised to use any topical creams or medications through an IV.  These absorption methods make things only slightly less of a problem because you are not having direct contact with your stomach lining.  The other problem remains that you are still reducing your production of prostaglandins.

Without prostaglandins, your stomach is open to an attack from its acid, which is dangerous after gastric bypass.

My experience with bariatric surgery and Ibuprofen

After my bariatric surgery, I was advised by my bariatric health care team to avoid any pain medication other than acetaminophen because of the vulnerable state my stomach was in.  I had the gastric sleeve, and my new stomach sleeve would be irritated with any use of an NSAID pain reliever as it healed.  I am glad I followed my doctors’ orders of not taking any NSAIDS because I had regular episodes of indigestion and stomach irritation before surgery, which had a high chance of flaring up again after surgery.

Stomach irritation is serious, and many bariatric patients suffer from stomach irritation, discomfort, and possible ulcers when their health is not carefully monitored or considered.  I have not had stomach irritation since my weight loss surgery due to carefully monitoring my medications and observing my digestion responses.