GI surgery and implications on administration of medicines

[Pharmguru]

If a patient has GI surgery and then has part of the absorption site removed, where, their oral medicine would be absorbed, you would need to look for alternate route of administration. However, in this situation would a liquid formulation of the same med be ruled out straight away as liquids also get dissoluted etc like tablets. Crushing tablets would also not be an option?

[DavidS]

Titration is standard practice will all repeat medication, whether or not the patient has lost part of the gut. We are all different.

[Nik]

Whole host of factors to consider here - depends on how much of the absorptive intestine has been resected or affected. GI surgery could mean anything from ileal resections to total or hemicolectomies. Removing extensive amounts of the small intestine can lead to short bowel syndrome (at least half of the small bowel) which can affect not just absorption of drugs but also nutrients. Adaptation of the remaining ileum can take place but it is a slow process. In patients who have stomas, high output post-op can easily lead to dehydration and so diuretics can be a problem.