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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Gout And Gastric Bypass
Posted: 05-09-05 21:58pm
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Does anyone know of any relation between
gout and gastric bypass? Considering
this procedure severely limits the amount
of food and fluids taken in I was
wondering if it might trigger an attack.
I can not find anything online about it.
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 05-12-05 12:03pm
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Do you know what are the blood uric acid
levels before and after the surgery when
there were no gout attack? Those info
can help explain why you have the gout
attack.
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Posted: 05-21-05 19:51pm
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Jyy2...I have not had the surgery yet, but
have considered it. I have a friend that
did have it and has no problems with gout,
but I will ask her to check with her
physician as to what the uric acid levels
might do as a result of the surgery.
Kingsmonarch
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 05-23-05 19:22pm
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Surgery and hospital stay are known to
trigger gout attacks in 20%~86% (?) of the
gout patients. Fasting and rapid weight
loss (and the results of gastric bypass?)
are also known to trigger gout attacks.
Therefore, gastric bypass patients seem to
be facing with double whammy from the
procedure. I have not read any report in
this regard. The following are my
unqualified thoughts about what I would
do:
before surgery:
1) keep taking allopurinol to lower and
stabilize the blood uric acid level.
2) start taking colchicine a few weeks
pre-op to prevent possible attack. (you
will be prohibited from taking nsaids 10
days or so pre-op & post-op to prevent
excess bleeding & hematosis.
After surgery
1) treat myself as if there is a gout
attack for a week or two without using
nsaids (and baking soda?)
2) go on high purine diet post-op to
stabilize the blood uric acid level to
reduce the chance of gout attacks.
I suggest you discuss the problem with
your doctor and the surgeon for advice.
Would you pass it on to us? Thanks and
good luck.
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Posted: 05-27-05 16:19pm
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It will be a while before I can afford the
surgery if I decide to do it, but I will
pass on any information I get, you can be
sure!
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 05-29-05 01:42am
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Just came across "gastric bypass -- for
doctors only" by alvarado bariatric
surgeons. Here are a few quotes:
* "post-op regimen ... Eat 2-3 meals per
day...In the form of lean meats (chicken,
turkey, fish) ..."
* "hyperuricemia frequently occurs during
the period of rapid weight loss,
associated with catabolism of large
volumes of tissue. Patients with a prior
history of gout, or hyperuricemia, should
be maintained on allopurinol..."
the webpage is at: http://www.Gastricbypass.Com/gastri
c%20bypass-for%20doctors%20only.Htm
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Posted: 06-06-05 19:36pm
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Thanks dmonty & jyy2, both very
informative sites.
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exit88
New User, Becoming EHEALTHy
Joined: 19 Nov 2005
Posts: 2
Location: San Francisco
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Posted: 11-19-05 20:59pm
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I began suffering from gout a few months
ago, started allopurinol about a month ago
and had gastric bypass surgery 10 days
ago.
I am recovering fairly well from surgery
but have had terrible pain in both feet
the past few days which I assume is gout
related. The really bad news is that
after gastric bypass one is supposed to
never again take nsaids except perhaps
celebrex.
You are right to be concerned about the
issue.
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 11-19-05 23:16pm
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Very sorry gout hit you and you can't take
nsaids. Check with the doctor to see if
it's ok for you to have a shot of
corticosteroid or adrenocorticotropic
hormone (acth). They can relieve the
gout attack almost instantly. You can
also ask about taking colchicine or
steroids by mouth. The above meds work
in different pathways than nsaids; it may
be ok for you to use them. You can also
ask about suppositories.
I understand once you started allopurinol
you are not to discontinue it even when
there are gout attacks. Celebrex doesn't
work very well for gout attacks; it's not
for treatment of gout attacks in uk.
Check with the doctor about these points
too.
Good luck and take care.
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Decided to Not Have Gastric Bypass
Posted: 12-13-05 02:36am
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After careful consideration I have decided
to not have the bypass surgery. In
speaking with people who have undergone
the surgery and in researching it I have
found that it does not cause gout, unless
you already have a tendency towards gout.
My lifestyle changed have already helped
me start to slowly loose weight without
triggering a gout attack (see my other
posting "no gout in 8 months"
I am told, though, after the body
adjusts to the severe change (takes about
a year to fully adjust) that those who got
gout in relation to it suffered fewer to
no attacks, so if you are considering the
surgery due to immediate health reasons
(and not just to loose weight) do not let
me discourage you.
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exit88
New User, Becoming EHEALTHy
Joined: 19 Nov 2005
Posts: 2
Location: San Francisco
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Posted: 12-17-05 17:23pm
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I got the colchicine and it was very
helpful and significantly reduced my foot
pain. Unfortunately I developed severe
pain in my abdomnial area two weeks ago
and was diagnosed in the emergency room
with a kidney stone. Since then the
kidney stone still seems to be knocking
around with only occasional moderate
pain.
However besides that the gastric bypass
seems to be working as promised and I am
losing weight.
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 12-28-05 13:40pm
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I am very glad you are in good health. As
you know, uric acid stones are caused by
hyperuricemia and acidic urine. In case
you are not taking alkalizer such as
sodium bicarbonate (baking soda), you may
like to talk to your doctor about taking
it. It can raise the urine ph to make
uric acid more soluble, thus can dissolve
the ua stones and even reduce the blood ua
level slightly. You may also like to
avoid low ph foods and drinks as they can
increase the acidity of urine and body
fluids. Take care.
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JYY2
Experienced User , Rather EHEALTHy
Joined: 05 Jun 2004
Posts: 227
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Posted: 07-14-07 14:21pm
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RE: kingsmonarch's "... gastric bypass
...does trigger gout in those who have
that tendency,..."
------------------------------------------
------------------------------------------
---------
Surgery and hospital stay are known to
trigger gout, especially in gout patients.
In addition, certain anesthesia can lower
the blood uric acid level rapidly and
potentially can trigger gout attacks. For
example, in a study, anesthesia Propofol
lowers the blood uric acid level from 4.7
mg/dL to 3.0 in one day whereas another
anesthesia Sevoflurane lowers uric acid
only from 4.9 to 4.0. You may like to
discuss the issue with the
anesthesiologist ahead of the surgery to
select the most appropriate anesthesia
that has the least potential to trigger a
gout attack. Good luck.
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Anesthesia And Gout
Posted: 10-15-07 15:23pm
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JYY2 - thank you for the information
regarding anesthesia and gout (see Gastric
Bypass and Gout.) I will review the
information with my Anesthesiologist
before the surgery. I am still waiting on
insurance approval. (My company just
changed insurance carriers so I have to go
through the process all over again! It
still will be worth it.)
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kingsmonarch
New User, Becoming EHEALTHy
Joined: 29 Apr 2005
Posts: 18
Location: California
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Reply to Exit88 & Jyy2
Posted: 11-29-07 20:00pm
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The reason those who have had Gastric
Bypass cannot take nsaids is because the
stomach pouch is so small, there is an 80%
or more chance of developing a bleeding
ulcer from the medication even if taken
with food. This is not something you want
to mess around with!
Check out JYY2's web page on how he cured
his gout! Baking Soda is something you
CAN take after the surgery. It really
helped my last gout attack end quickly.
Hopefully it will work for you.
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