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[15] The main factor that affects the duration of biodegradation is the availability of acetylesterase and cellulase enzymes

[18] After sleeve gastrectomy, if NSAIDs are considered essential following individual risk assessment, they should only be used: At the lowest effective dose For the shortest possible duration With concurrent gastroprotection (e.g., a PPI such as omeprazole 20 mg daily) Under close medical supervision Most NHS bariatric units provide patients with written post-operative guidance that explicitly lists ibuprofen and other NSAIDs as medicines to avoid or use only under medical advice