Nonsteroid anti-inflammatory drugs and the risk of peptic ulcers after gastric bypass and sleeve gastrectomy

Marginal ulcer after mini gastric by-pass and sleeve gastrectomy with transit bipartition

“…Risk factors that facilitate marginal ulcer occurrence after BMS have been the focus of attention for many researchers. Different risk factors for marginal ulcers have been identified in studies (6,13,21,25). There was no significant difference between the patients with and without marginal ulcer in terms of the parameters we examined in this study, possibly due to the relatively low incidence of marginal ulcer in our patients.…”

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“…In a population-based cohort study, risk factors for marginal ulcer development were investigated in 20,294 GBP patients, and it was stated that the presence of diabetes and a history of peptic ulcer were the most important risk factors, while hyperlipidemia, hypertension, chronic obstructive pulmonary disease, low-dose aspirin and NSAID use were not risk factors (26). In various studies, use of NSAIDs for more than 30 days, active smoking or smoking history, use of immunosuppressive drugs, preoperative gastroesophageal reflux disease, diabetes, dyslipidemia, coronary artery disease, chronic lung disease, time elapsed after surgery, inhaled steroid use, and gastric pouch location and its size were identified as risk factors for marginal ulcer development after RY-GBP (5,6,13,21,27,28). The pathophysiological effects of these risk factors have not been clarified.…”

“…The incidence of marginal ulcer after BMS has been reported in a very wide range, from 0.35% to 25% (4,5). Studies claim that various factors contribute to the pathophysiology of marginal ulcer, including high acidity due to large pouch size or gastro-gastric fistula, loss of protective effects provided by pancreatobiliary secretions in the jejunum (due to gastrojejunal anastomosis), helicobacter pylori, local ischemia, foreign bodies (e.g., suture material), suture technique, smoking, corticosteroid and non-steroidal antiinflammatory drug (NSAID) use (2,6,7). However, the roles of these factors in the pathophysiology of marginal ulcers have not been clarified.…”

Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management

“…The use of NSAIDs impacts the GI mucosa primarily by inhibiting cyclooxygenase, reducing prostaglandins, and decreasing blood flow, which leads to a decrease in bicarbonate and mucus secretion [ 51 ]. While multiple studies have reported an increased risk of MU with NSAID use [ 14 , 20 , 44 , 52 ], others have found no association [ 17 , 22 , 28 ]. This variation might be due to differences in study designs, NSAID types and dosages, duration of use, and patient reporting.…”

“…This variation might be due to differences in study designs, NSAID types and dosages, duration of use, and patient reporting. Several studies have demonstrated that short-term use (<30 days) and low doses of NSAIDs and aspirin may not increase the risk of MU, whereas higher doses and chronic use do [ 28 , 44 , 52 ]. Therefore, it is recommended to avoid using NSAIDs after surgery, as they may potentially contribute to the development of MU.…”