Unhealthy Cocktail After Stomach Surgery

Alcohol abuse care twice as likely in gastric bypass patients than in those using other methods

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When the weight won't come off, patients can consider surgery on their stomachs to shed the pounds. Though surgery can be helpful in losing weight, one procedure might have more risks than others when it comes to drinking alcohol.

Patients had a two-fold increased chance of needing care for alcohol abuse after having gastric bypass surgery compared to patients who had restrictive banding on their stomachs.

Though the risk is higher, researchers said that patients should not be dissuaded from considering gastric bypass as an option for weight loss.

"Consider your surgical weight loss options."

Researchers, led by Magdalena Plecka Ostlund, MD, PhD, from the Upper Gastrointestinal Research Unit at the Karolinska Institutet, examined the odds of alcohol dependence before and after gastric bypass surgery compared to restrictive surgery.

In gastric bypass, the stomach and small intestines are surgically altered to allow less food to be eaten and to change how the intestines absorb nutrients.

Restrictive surgery involves banding the stomach to make it smaller and tighter. Both procedures are often used to help patients lose weight.

The study included more than 11,000 adult patients who had primary gastric bypass, vertical banded gastroplasty or gastric banding done between January 1980 and December 2006 in hospitals across Sweden.

Almost two-thirds of patients had some kind of restrictive surgery while the rest had gastric bypass. Patients were 40 years of age on average and more than three quarters were women. Researchers pulled data from several Swedish databases.

Researchers assessed inpatient care for several conditions, including substance abuse, alcohol abuse, depression and attempted suicide. They tracked patients a little more than five years on average after their procedures.

Before surgery, inpatient treatment for alcohol abuse was no different for patients who underwent gastric bypass versus any of the restrictive procedures.

After surgery, the odds of needing inpatient care for alcohol abuse were 2.3 times higher among patients who had gastric bypass than among those who had a restrictive surgery.

"The most striking finding of this study was that patients who had undergone gastric bypass were significantly more likely to develop alcohol abuse than those who had undergone a restrictive procedure...," researchers wrote in their report.

"Despite this increased risk, patients should not be dissuaded from gastric bypass since the improvement in their metabolic status is significant," they wrote.

After having gastric bypass, patients have a higher peak alcohol level and their bodies take longer to get the alcohol out of their system.

Because the stomach is smaller, researchers said that less alcohol is degraded before it enters the intestine. Gender also plays a role in the breakdown of alcohol.

"Most patients who undergo gastric bypass are women, and sex clearly plays a role in alcohol metabolism, with men having higher alcohol dehydrogenase activity in the liver than do women," researchers wrote.

Some of the study's in-hospital data might have been misclassified or underreported at the time patients were discharged from the hospital, researchers noted.

Researchers also did not have any data for outpatient care, which might have underestimated their results. Another limitation of the study was that the proportion of patients who had gastric bypass and abused alcohol might have increased.

The study, which was supported by the Swedish Research Council, the Swedish Cancer Society and the Stockholm County Council, was published online April 17 in JAMA Surgery.

No conflicts of interest were reported.

Reviewed by: 
Review Date: 
April 17, 2013
Last Updated:
August 14, 2013