What Pain Medication Can You Take After Gastric Bypass?

There are different medications that may be prescribed to you after bariatric surgery. This will most likely include pain medications. These medications will be able to effectively control your post-operative discomfort. 

Some patients may experience mild to moderate pain, while others will experience more severe pain. The pain medication your physician prescribes is important to assist you in a quick recovery.

This article will help you to understand pain medications, as well as additional medications prescribed following surgery. This article will also provide warnings against the use of certain drugs that will adversely affect recovery and health post-surgery. 

 

A Guide to Pain Medication Post-Bariatric Surgery

Pain Medications after Bariatric Surgery

Restrictive and malabsorptive bariatric procedures can have different effects on drug absorption. Some medications require an acidic stomach environment to be dissolved, but gastric acid is severely decreased after bariatric surgery. Medications should not be taken without the direction of your healthcare provider.

Pain following Gastric Bypass Surgery can be controlled effectively with the use of non-opioid and/or opioid pain medications. These medications will be prescribed by your physician in the days that follow your Bariatric Surgery. 

It is important to obtain control over your pain early on after your surgery. This is usually done by starting with stronger pain medications and then “downscaling” to other medications. 

If pain is not controlled early on post-operatively, it becomes difficult to control pain later in the post-operative period and this can lead to delayed recovery.

Non-Opioid Pain Medication

Commonly prescribed non-opioid pain medication following Bariatric Surgery is Acetaminophen, aka Tylenol. 

Keep in mind, Acetaminophen in large doses can cause liver damage. 

Non-opioid medication is preferred for controlling mild to moderate pain.

Opioid Pain Medication

Opioid medication should be reserved for severe pain which may not be well controlled by non-opioid pain medication. Opioids should be used conservatively due to their side effects and addictive properties.

The rule with opioids is to use them at their lowest effective dose and for the shortest time possible. 

Commonly prescribed opioids include:

  • Hydrocodone
  • Morphine
  • Oxycodone

Combinations between non-opioids and opioids include:

  • Codeine with Acetaminophen
  • Oxycodone with Acetaminophen

Side effects can include:

  • Nausea
  • Constipation
  • Dizziness
  • Large doses may abnormally effect breathing
  • Long term use can lead to addiction

 

Pain Medications to Avoid after Gastric Bypass Surgery

Avoid all pain medication that is considered a non-steroidal anti-inflammatory (NSAID) drug until your physician instructs you otherwise. 

NSAIDs include: 

  • Ibuprofen (Advil, Motrin)

  • Naproxen (Aleve)

  • Celecoxib (Celebrex) 

  • Asprin (Bayer)

NSAIDs have been shown to increase the development of stomach ulcers, perforations, and leaks in the gastrointestinal tract. If they can not be avoided consult with your healthcare provider. Proton Pump Inhibitors may be considered to decrease stomach acid.

Stomach ulcers are more difficult to diagnose and treat in the post-operative period. 

When you should contact your physician:

  • If you experience any abnormal bleeding or vomiting with blood in it
  • If you experience unacceptable side effects
  • If you experience severe pain, despite using adequate pain medication

 

What Other Medications Will I be Prescribed After Bariatric Surgery?

After the bariatric procedure, you will likely be restarted on medications for previous chronic medical conditions. The dosages of these medications may be changed due to the altered absorption in your digestive system due to weight loss surgery. This will be determined by your prescriber. 

Crushed or liquid-rapid release medications should be used instead of extended-release medications to ensure absorption immediately post-operation. If a pill can be crushed or a capsule can be opened, this may be the recommended use considered by your bariatric team.

Some of the medications you receive following surgery will be for long-term use. 

Proton Pump Inhibitor (PPI)

Antacid medication, known as a proton pump inhibitor (PPI), will be prescribed for preventative purposes. Some individuals may be recommended continued use even a year after weight loss surgery based on history of ulcers. 

Omeprazole (Prilosec) is an example of a PPI. They assist in the prevention of stomach ulcers by decreasing the acid content in your stomach and small intestine. Ulcers can be a risk in patients who have undergone Bariatric Surgery. 

Bile Acid

A bile acid, called Ursodiol, will be prescribed for prevention of gallbladder issues. This medication will prevent the formation of gallstones. Gallstones can be an unfortunate side effect from significant weight loss after bariatric surgery. 

Birth Control

Weight loss surgery has been shown to increase fertility. Effective birth control will be encouraged for women up to 2 years following bariatric surgery. 

There are very high risks of nutrient deficiencies for you and your child. Complications of early pregnancy after bariatric surgery can result in preterm birth, small for gestational age, and growth restrictions.

 

What Medications to Purchase Before Bariatric Surgery?

Bariatric specific multivitamins will be taken for life after bariatric surgery. Your healthcare provider may even recommend you start taking them before surgery in a lower dosage to start prevention or correct current deficiencies. 

There is a high risk of vitamin and mineral deficiencies after any bariatric procedure. For preventative purposes, you will be recommended a bariatric specific multivitamin for life.  A chewable multivitamin is typically recommended initially following surgery for healing, toleration and absorption purposes. 

Bariatric specific means that the nutrient content aligns with the ASMBS

guidelines for bariatric patients. These guidelines consider the malabsorption and restriction after weight loss surgery and provide specific vitamin and mineral recommendations.

Some common vitamins and minerals that will be highlighted are Calcium, Vitamin D, Vitamin B12, and Iron. Other micronutrients will include Zinc, Copper, Vitamin B6, Folic Acid, Thiamin and Vitamin A. 

A deficiency of a number of these micronutrients can cause a wide variety of symptoms like fatigue, hair loss, irritability, anemia, etc. 

Before considering additional supplements, hair loss should be addressed first by ensuring you are:

- Staying consistent with your bariatric specific multivitamin
- Reaching daily protein goals (minimum of 60g - 80g protein/day, follow protein recommendations provided by your dietitian)
- Daily water intake (48-64oz)
- Consuming a variety of whole foods
- Blood work (this will show if a vitamin/mineral deficiency is the cause of hair loss)

and Vitamin A. 

If all of these points have been addressed, then you may be interested in a supplement to minimize hair loss

Your post-operative diet should also be rich in protein, micro and macronutrients. A registered dietitian can assist you in your post-operative diet. 

 

Non-Pharmaceutical Interventions

Early mobilization post-surgery is important in accelerating the road to recovery.  

When medically feasible and recommended by your practitioner, getting out of bed and doing light exercise can allow you to focus less on pain and improve mood.

Diet after surgery should be a healthy and balanced, including protein at each meal. If you are having a hard time reaching your daily protein goals, you may want to consider a protein supplement or high protein meal replacement. 

A suitable diet after bariatric surgery should be a discussion between you and a registered dietitian.

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**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.