DUMPING SYNDROME FROM VAGOTOMY AND PYLOROPLASTY OP
| Discussion in 'All Categories' started by NEVILLE STRINGER - Mar 2nd, 2013 4:43 pm. | |
NEVILLE STRINGER
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I had this op 33 years ago and thou I suffer with pain and diarrhoea I try to not let the condition control me.I would love someone to answer this question for me. when taking vitamins, supplements or medications they are usually coated or are contained in a gel like shell capsule to protect them as they enter the stomach, when i swallow these do they have to brake down their barrier in the stomach acid to be effective further along the digestive tract, I am asking this because I am assuming that my stomach does not produce enough acid to remove the coating or brake down the capsule shell and also the tablet will travel much quicker through my digestive tract therefore will my system absorb and benefit from the contents of tablet, if not how can i work around this. |
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re: DUMPING SYNDROME FROM VAGOTOMY AND PYLOROPLASTY OP
by Dr J S Chowhan -
Mar 4th, 2013
8:18 am
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Dr J S Chowhan
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DEAR NEVILLE STRINGER Coated capsule are not good for bypass patient as it absorbed across the intestinal wall as a solid. It must first dissolve in the fluid of the G-I tract. Tablets for bypass patient capsule are carefully formulated, designed, to stay together in the bottle during transport but break up quickly once they are in an aqueous environment. Normal patient pH of the stomach pouch is as high as 6.8, so most medications need to be crushed to enhance dissolution Medications in bypass patient. Capsule Should be crushed or liquid form for 3- 8 weeks after surgery. Pills should not be larger than the diameter of a pencil tip eraser, if it the size of a thumbnail or more, it will require, splitting, crushing, opening of capsules or grinding depending on the formulation. No sustained release or enteric coated products should be given to bypass patient. To minimize dumping syndrome, avoid products, including OTC with sucrose, corn syrup, lactose, maltose, fructose, honey and mannitol. Avoid sustained release or enteric coated drugs. Long absorptive drugs (SR, ER) are absorbed over 2-12 hour. Pass through the GI before absorption is complete. Substitute with immediate release drugs and increase the frequency. Roux-en-Y bypass reduces the surface area. Villi and microvilli of small intestine (SI) have greater surface area than the large intestine. Bypass duodenum and jejunum. Digoxin absorption may be affected. Please keep in touch with dietitian. With regard JS Chowhan |