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Erschienen in: Obesity Surgery 9/2017

10.04.2017 | Original Contributions

Omeprazole Absorption and Fasting Gastrinemia After Roux-en-Y Gastric Bypass

verfasst von: Renata V. A. Collares-Pelizaro, José S. Santos, Carla B. Nonino, Cristiane M. Gaitani, Wilson Salgado Jr

Erschienen in: Obesity Surgery | Ausgabe 9/2017

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Abstract

Purpose

Roux-en-Y gastric bypass (RYGB) is one of the bariatric surgeries most frequently performed worldwide. Since this operation may predispose to the formation of peptic ulcer of the gastrojejunal anastomosis, the use of proton pump inhibitors (PPI) is recommended during the first postoperative year. However, so far, there is no detailed knowledge about the absorption of this medication during the immediate postoperative period and consequently about its effectiveness in blocking acid secretion. The objective was to assess the possible endoscopic peptic changes, the absorption of omeprazole (OME), and the status of fasting gastrinemia before and after RYGB operation.

Materials and Methods

OME absorption, the production of its metabolites omeprazole sulfone (OMES) and 5-hydroxyomeprazole (HOME), and basal (fasting) gastrinemia were determined in patients submitted to RYGB before and 2 months after the operation. Upper digestive endoscopy (UDE) was also performed before and 6 months after the operation.

Results

Twenty patients were studied. Preoperatively, all these patients had some peptic changes and 55% tested positive for Helicobacter pylori. Six months after surgery, ten patients still showed endoscopic changes and one patient tested positive for H. pylori. During the postoperative period, there was a reduction of OME absorption and of the production of its metabolites 90 min after administration of the drug, and reduction of serum gastrin levels.

Conclusion

The standard OME dose (40 mg) administered after bariatric surgery is insufficient to achieve serum levels that can effectively block the production of hydrochloric acid, permitting the formation of peptic injuries in many patients.
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Metadaten
Titel
Omeprazole Absorption and Fasting Gastrinemia After Roux-en-Y Gastric Bypass
verfasst von
Renata V. A. Collares-Pelizaro
José S. Santos
Carla B. Nonino
Cristiane M. Gaitani
Wilson Salgado Jr
Publikationsdatum
10.04.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2672-z

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