Is it safe to have endometriosis and get a gastric bypass?

Question

I have a history of having endometriosis and for years I’ve been taking a lot of ibuprofen during that time of the month. Im worried when I go into surgery the doctor will find ulcers of something worse and not be able to get the sleeve done. Will the doctor know if I’ll be able to get gastric sleeve before going into surgery? And what’s the worst scenario if I have ulcers? Thank you in advance

Ali Solmaz, MD · Answer

It's definitely possible to have endometriosis and undergo gastric bypass or gastric sleeve surgery, but your history of long-term ibuprofen use raises some concerns. NSAIDs like ibuprofen can irritate the stomach lining, increasing the risk of gastritis and ulcers. Since gastric bypass further raises the risk of ulcers, most surgeons recommend stopping NSAIDs before and after surgery.
Before the procedure, bariatric programs usually require an upper endoscopy (EGD) to check for any ulcers or stomach issues. If an ulcer is found, your surgeon may delay surgery until it heals and may prescribe medication like proton pump inhibitors (PPIs) to treat it. If ulcers are discovered during surgery, the surgeon may not be able to proceed with the gastric sleeve or bypass, depending on the severity. If the sleeve is done with an existing ulcer, it can increase the risk of complications like leaks, perforation, or poor healing.
To prepare, you should ask for an upper endoscopy before surgery, stop taking ibuprofen, and switch to Tylenol or other alternatives. Your doctor may also recommend starting a PPI like omeprazole to help protect your stomach. Since NSAIDs won’t be safe after surgery, it’s important to discuss alternative pain management options for your endometriosis with your bariatric team.

Pablo Garcia, MD - Account Suspended · Answer

Hello, I am sorry you struggle with this issue. Endometriosis is not a contraindication to bariatric surgery, although you would have to be closely followed due to possible iron loss anemia, assuming you have a very heavy flow. In regards to the ulcers, you could not undergo surgery while having an active ulcer. As part of your pre operative evaluation, you would need to get some tests including an uper GI endoscopy, which would determine if you have any ulcers and on what stage. In that case, your ulcer would be treated before considering surgery.

Mark Pleatman, MD (retired) · Answer

You are asking about gastric bypass but then mentioning sleeve gastrectomy.  There's a difference!  The only way to see if you have ulcers is to get an endoscopy done before surgery; they aren't seen from the laparoscopic approach.  The endometriosis itself won't affect the surgery; but if you need to be taking ibuprofen AFTER surgery, you shouldn't have a gastric bypass.  One of the advantages of sleeve gastrectomy is that you are allowed to take nonsteroidal anti-inflammatory agents after the surgery.  With gastric bypass, there is a high risk of ulcers if you take these medications.

Is it safe to have endometriosis and get a gastric bypass?

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