Citation

Acevedo MB, Teran-Garcia M, Bucholz KK, Eagon JC, Bartholow BD, Burd NA, Khan N, Rowitz B, Pepino MY. Surg. Obes. Relat. Dis. 2020; ePub(ePub): ePub.

Affiliation

Department of Food Science and Human Nutrition, College of Agricultural, Consumer and Environmental Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois. Electronic address: ypepino@illinois.edu.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.soard.2020.01.014

PMID

32075778

Abstract

BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol's sedative effects.

OBJECTIVES: To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. SETTING: University medical centers in Missouri and Illinois.

METHODS: Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing postsurgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking.

RESULTS: In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery (P <.001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (-2.3 ±.3 versus -1.2 ±.2; P <.05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects.

CONCLUSIONS: Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.

Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Alcohol; Bariatric surgery; Ethanol; Laparoscopic adjustable gastric banding surgery; Metabolic surgery; Pharmacokinetics; Roux-en-Y gastric bypass; Sleeve gastrectomy; Subjective response