REQ: post roux and y gastric bypass oral medication malapsorption?



Hello all, I am relatively new to the group and hope I am following
proper protocol in posting this query.

My pain management (PM) physician disagree's with my assumption
(anecdotal as it is - without any published data to back my idea up)
that like supplements, non pain related medications and the like are
not absorbed as readily or in the amounts of the meds and therefore
usually need an upward titration to compensate.

I was told (pre-surg) that for the rest of my life, this could be an
issue and I have to eat slightly more protein than non-bypass patients,
take a pre-natal chewable vitamin every day (I am a MALE and YES I said
pre-natal), and 2000mg calcium per day. After mentioning my surgery to
other non-pain related physicians, the seemed to understand the concept
and agreed to titrate up if necessary and this has worked well, except
with my pain management physician even after complaining that I was
experiencing significat and distracting pain to the point where I could
basicly not do more than lay in bed all day and night (Laminectomy with
fusion L5S1, diffuse disc bulging and pain, herniated cervical disc).

After a psyhiatric review by my pain-doc's psychologist, he
(Psychologist - yes I know he cannot render medical opinions) seemed
to agree that malapsorption could be in issue and that it should be
addressed by my pain doc and there are plenty of different meds at my
PM's disposal to try to get me moving more toward a less painful life
and be more productive. Good for me all around he thought.

My PM told me he disagrees with the absorption problem and said nothing
further and did not adjust my meds at all or offer any alternative. He
has prescribed me Duragesic patches and roxicodone for break through
but it just never seems to dull the distracting burning/aching that has
screwed up my life.

My question is, does anyone know of any medical literature or some-such
that would confirm or suggest that post gastric bypass patients have
oral medication absorption issues?

Thank you for considering my Information Request.


"I want to shine on in the hearts of man, I want them eating from my
broken hand"