PPI's, ulcers and old stomach questions

[itsmekarenlee 129]

Hi vets :-) I had GERD and was taking script prilosec every day for many years. I'm still on it since my rny a week ago but have been thinking...... the prilosec won't get to my old stomach anymore but it is still producing stomach acid so is it inevitable that I'll get an ulcer someday? Or does the prilosec go systemic and still help with that?

[green*eyed*girl 170]

Well, I am not a vet but this is an excellent question, I am only 3 months out but this is a big question in my head too.

Like I understand the importance of my PPI when it comes to my "new" stomach, but what happens to the bypassed tummy??? Because it is just sits there and produces acid and it's not like my PPI will ever get to it to to turn off the pumps that are producing the acid? I am not sure the PPI goes systematic, I have researched it on the internet but didn't find much about the bypassed stomach. I will sure to ask my doctor the next time I see him...

[itsmekarenlee 129]

Exactly. I have a friend who has a bypass and I believe she got ulcers on her former stomach and almost died. I certainly don't want that happening!

[green*eyed*girl 170]

Yes, I can see that coming. I will see my GP in a week or two and I will ask him, but honestly I do not think he will have an answer as he is not a bariatric surgeon or an expert on this field. The next time I will see my surgeon is going to be in October, hopefully he will have some answers... When are you going to talk to your surgeon?

[green*eyed*girl 170]

"Might there be any advantages to removing the stomach remnant? Well, there is one mostly theoretical advantage. It has to do with the possibility of stomach ulcer formation in the stomach body or remnant. In some unusual cases, gastric or duodenal ulcers can still form in the bypassed stomach remnant or duodenum, but because of the bypass we no longer have easy access to endoscopically inspect the lining of these structures as we do under normal circumstances. So if a person is having unexplained pain and they have had a gastric bypass, we are not as easily able to perform upper endoscopy (passing a flexible camera tube down into the stomach and duodenum to inspect for ulcers or irritation of the lining). The same would hold true if a tumor were forming in one of these areas. Doctors could investigate with other types of studies, namely imaging studies like CT scan, MRI or ultrasound. Or, if it was felt to be highly important to inspect endoscopically, then the endoscopy could be performed surgically with an incision through the abdominal wall."

http://www.sasseguide.com/blog/what-happens-to-the-%E2%80%9Cold-stomach%E2%80%9D-in-gastric-bypass/

[itsmekarenlee 129]

Well, we just found out the morons at his office made all of our other appts except the two week post op. I haven't been happy and should have trusted my gut at orientation but hubby felt comfortable with him.

I will call tomorrow and get an appt for late next week or early the week after.

I'm starting to ask myself why the hell I did this to myself.

[itsmekarenlee 129]

I would be curious to hear what other drs say. My Dr would probably know but I will always question even his answers.

[DLCoggin 1,788]

I am a vet but most certainly not a doctor. That said, it is my understanding that your stomach produces acids in response to the presence of food. It is also my understanding that most acid is produced in the upper part of stomach (the fundus) which is used to form the pouch.

Since your "stomach" (as opposed to your pouch) no longer receives food, and the majority of stomach acid is produced in that part of the stomach used to create the pouch, I suspect that acid production in the stomach would be dramatically reduced if not eliminated. I'll be three years out in October and have had no problem. There are others who had RNY twenty years ago or more. I have never read of anyone having a problem with ulcers in the "stomach". I have done and continue to do a considerable amount of research. I've never read or even heard of a clinical study focused on ulcers in the "stomach" following RNY. That does not mean it never happens, but I suspect it is rare.

Ulcers at the anastomosis of the pouch are fairly common following RNY (about 15%). I developed one about six months post-op. My surgeon doubled my Rx for Prevacid and 90 days later a second endoscopy confirmed the ulcer was completely healed. There was no other treatment prescribed or needed. Just the change from one pill to two and it took care of it.

Your question is an interesting one and I think many of us would be interested in what your doctor's response is when you have the opportunity to discuss it.

[itsmekarenlee 129]

Thank you! :-) that's insightful. We see him on Wednesday and I'll ask.

I know my friend got an ulcer in her old stomach and almost died so yes, I'm a bit curious what his answer is going to be.

[itsmekarenlee 129]

He just said it's rare.

He also said he has his patients on omaprezole for 30 days after surgery.

And unrelated to those answers I'm changing bariatric drs. I'm tired of him making me feel like he's annoyed with me my questions, among other this. I've had enough.

[green*eyed*girl 170]

My doc makes me take Omeprazol for life...

[itsmekarenlee 129]

My doc makes me take Omeprazol for life...

I think I would feel better taking it for life too. I hear of people getting ulcers where the sutures were and omaprozole hero's to protect that from happening. I don't know, this is all so confusing.

[freelyme 149]

You can google omeprazole and look under the pharmacokinetic section. This will relay that it is systemically absorbed. Hope this helps.