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

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A Correction to this article was published on 18 October 2017

An Erratum to this article was published on 24 August 2017

This article has been updated

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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Change history

  • 18 October 2017

    Larissa Alves dos Reis Dias wasmistakenly included in the 13 acknowledgment section of this article, and was mistakenly.

  • 24 August 2017

    An erratum to this article has been published.

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Acknowledgments

Larissa Alves dos Reis is gratefully acknowledged.

Author information

Authors and Affiliations

  1. Department of Surgery and Anatomy, Clinical Hospital, Faculty of Medicine, University of São Paulo, Ribeirão Preto, Brazil

    Renata V. A. Collares-Pelizaro, José S. Santos & Wilson Salgado Jr

  2. Department of Clinical Analysis, Toxicology and Bromatology, Faculty of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, Brazil

    Carla B. Nonino

  3. Nutritional Division of the Department of Medical Clinic, Clinical Hospital, Faculty of Medicine, University of São Paulo, Ribeirão Preto, Brazil

    Cristiane M. Gaitani

Authors
  1. Renata V. A. Collares-Pelizaro
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  2. José S. Santos
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  3. Carla B. Nonino
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  4. Cristiane M. Gaitani
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  5. Wilson Salgado Jr
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Corresponding author

Correspondence to Wilson Salgado Jr.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance and approved by the Research Ethics Committee of the HCFMRP-USP and also by the National Health Council, and Ethics in Research National Committee of the Brazilian Health Ministry, with the ethical standards and respecting the 1964 Helsinki declaration and its later amendments.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Financial Support

The financial support received was from FAEPA—Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo and Fundação Waldemar Barnsley Pessoa, Hospital São Francisco Ribeirão Preto, SP.

Additional information

A correction to this article is available online at https://doi.org/10.1007/s11695-017-2956-3.

An erratum to this article is available at https://doi.org/10.1007/s11695-017-2910-4.

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Collares-Pelizaro, R.V.A., Santos, J.S., Nonino, C.B. et al. Omeprazole Absorption and Fasting Gastrinemia After Roux-en-Y Gastric Bypass. OBES SURG 27, 2303–2307 (2017). https://doi.org/10.1007/s11695-017-2672-z

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  • DOI: https://doi.org/10.1007/s11695-017-2672-z

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