Patients who have had Roux-en-Y gastric bypass performed and have subsequently developed marginal ulcerations will get a better response to proton pump inhibitors if they open up the capsules first, as opposed to swallowing them whole. To reach that conclusion, investigators performed a retrospective analysis of 162 patients and found:

• It took a median of 91 days for ulcers to heal in patients who opened proton pump capsules, compared to 342 days for patients taking intact capsules.
• Patients using open capsules required fewer endoscopic procedures and fewer healthcare resources.

Researchers believe the improved outcomes in patients who opened the capsules occurred because gastric bypass results in a small gastric pouch and rapid small bowel transit. Both these factors reduce a patient’s ability to breakdown capsules and absorb their contents.