Which class of medications should be avoided due to risk of stomach ulcers after bariatric surgery?

• A. Antibiotics
• B. NSAIDs
• C. Antihistamines
• D. Beta-blockers

Answer: (B)

After bariatric surgery, the stomach lining is more vulnerable to injury, so medications that irritate or damage the stomach should be avoided. NSAIDs are the class to avoid because they blunt the stomach’s protective defenses. They block COX enzymes and reduce prostaglandin production, which normally helps the stomach by increasing mucus and bicarbonate, promoting blood flow, and supporting healing. With fewer protective prostaglandins, acid can more easily injure the lining, leading to ulcers, especially in the surgically altered anatomy where healing surfaces are exposed. So, for pain relief, safer options like acetaminophen are preferred, and NSAIDs should be avoided unless a clinician specifically approves with appropriate precautions.

The other options aren’t typically associated with a high ulcer risk in this setting, so they aren’t the ones to avoid for this reason.