Sleeve gastrectomy surgery: when 2 alcoholic drinks are converted to 4

María Belén Acevedo, J. Christopher Eagon, Bruce D. Bartholow, Samuel Klein, Kathleen K. Bucholz, Marta Yanina Pepino de Gruev

Research output: Contribution to journalArticle

Abstract

Background: While it is well established that Roux-en-Y gastric bypass (RYGB) causes a rapid and heightened peak blood alcohol concentration (BAC), results from previous studies on the effects of sleeve gastrectomy (SG) on alcohol pharmacokinetics are conflicting. Data from 2 studies found SG did not affect BAC, whereas another study found SG caused a heightened peak BAC after alcohol ingestion. Moreover, these 3 studies estimated BAC from breathalyzers, which might not reliably estimate peak BAC. Objectives: The aims of this study were to evaluate (1) the effect of SG, relative to RYGB and a presurgery group, on alcohol pharmacokinetics and subjective effects, and (2) whether breathalyzers are reliable in this population. Setting: Single-center prospective nonrandomized trial. Methods: We performed alcohol challenge tests in 11 women who had SG surgery 1.9 ±.1 years ago (body mass index = 35.1 ± 6.6 kg/m 2 ), 8 women who had RYGB surgery 2.2 ±.4 years ago (body mass index = 30.0 ± 5.2 kg/m 2 ), and 9 women who were scheduled for bariatric surgery (body mass index = 44.1 ± 4.0 kg/m 2 ). BACs were estimated from breath samples and measured by gas chromatography at various times after consuming approximately 2 standard drinks. Results: BAC increased faster, peak BAC was approximately 2-fold higher, and feelings of drunkenness were heightened in both SG and RYGB groups relative to the presurgery group (P values<.001). BAC estimated from breath samples underestimated BAC by 27% (standard deviation = 13%) and missed peak BACs postsurgery. Conclusions: SG, similar to RYGB, causes marked alterations in the response to alcohol ingestion manifested by a faster and higher peak BAC. The breathalyzer is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol.

Original languageEnglish (US)
Pages (from-to)277-283
Number of pages7
JournalSurgery for Obesity and Related Diseases
Volume14
Issue number3
DOIs
StatePublished - Mar 2018

Fingerprint

Gastrectomy
Gastric Bypass
Alcohols
Body Mass Index
Pharmacokinetics
Eating
Blood Alcohol Content
Alcoholic Intoxication
Bariatric Surgery
Gas Chromatography
Stomach
Emotions

Keywords

  • Alcohol
  • Bariatric surgery
  • Breathalyzer
  • Ethanol
  • Metabolic surgery
  • Pharmacokinetics
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Sleeve gastrectomy surgery : when 2 alcoholic drinks are converted to 4. / Acevedo, María Belén; Eagon, J. Christopher; Bartholow, Bruce D.; Klein, Samuel; Bucholz, Kathleen K.; Pepino de Gruev, Marta Yanina.

In: Surgery for Obesity and Related Diseases, Vol. 14, No. 3, 03.2018, p. 277-283.

Research output: Contribution to journalArticle

Acevedo, María Belén ; Eagon, J. Christopher ; Bartholow, Bruce D. ; Klein, Samuel ; Bucholz, Kathleen K. ; Pepino de Gruev, Marta Yanina. / Sleeve gastrectomy surgery : when 2 alcoholic drinks are converted to 4. In: Surgery for Obesity and Related Diseases. 2018 ; Vol. 14, No. 3. pp. 277-283.
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abstract = "Background: While it is well established that Roux-en-Y gastric bypass (RYGB) causes a rapid and heightened peak blood alcohol concentration (BAC), results from previous studies on the effects of sleeve gastrectomy (SG) on alcohol pharmacokinetics are conflicting. Data from 2 studies found SG did not affect BAC, whereas another study found SG caused a heightened peak BAC after alcohol ingestion. Moreover, these 3 studies estimated BAC from breathalyzers, which might not reliably estimate peak BAC. Objectives: The aims of this study were to evaluate (1) the effect of SG, relative to RYGB and a presurgery group, on alcohol pharmacokinetics and subjective effects, and (2) whether breathalyzers are reliable in this population. Setting: Single-center prospective nonrandomized trial. Methods: We performed alcohol challenge tests in 11 women who had SG surgery 1.9 ±.1 years ago (body mass index = 35.1 ± 6.6 kg/m 2 ), 8 women who had RYGB surgery 2.2 ±.4 years ago (body mass index = 30.0 ± 5.2 kg/m 2 ), and 9 women who were scheduled for bariatric surgery (body mass index = 44.1 ± 4.0 kg/m 2 ). BACs were estimated from breath samples and measured by gas chromatography at various times after consuming approximately 2 standard drinks. Results: BAC increased faster, peak BAC was approximately 2-fold higher, and feelings of drunkenness were heightened in both SG and RYGB groups relative to the presurgery group (P values<.001). BAC estimated from breath samples underestimated BAC by 27{\%} (standard deviation = 13{\%}) and missed peak BACs postsurgery. Conclusions: SG, similar to RYGB, causes marked alterations in the response to alcohol ingestion manifested by a faster and higher peak BAC. The breathalyzer is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol.",
keywords = "Alcohol, Bariatric surgery, Breathalyzer, Ethanol, Metabolic surgery, Pharmacokinetics, Sleeve gastrectomy",
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AU - Acevedo, María Belén

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AU - Klein, Samuel

AU - Bucholz, Kathleen K.

AU - Pepino de Gruev, Marta Yanina

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AB - Background: While it is well established that Roux-en-Y gastric bypass (RYGB) causes a rapid and heightened peak blood alcohol concentration (BAC), results from previous studies on the effects of sleeve gastrectomy (SG) on alcohol pharmacokinetics are conflicting. Data from 2 studies found SG did not affect BAC, whereas another study found SG caused a heightened peak BAC after alcohol ingestion. Moreover, these 3 studies estimated BAC from breathalyzers, which might not reliably estimate peak BAC. Objectives: The aims of this study were to evaluate (1) the effect of SG, relative to RYGB and a presurgery group, on alcohol pharmacokinetics and subjective effects, and (2) whether breathalyzers are reliable in this population. Setting: Single-center prospective nonrandomized trial. Methods: We performed alcohol challenge tests in 11 women who had SG surgery 1.9 ±.1 years ago (body mass index = 35.1 ± 6.6 kg/m 2 ), 8 women who had RYGB surgery 2.2 ±.4 years ago (body mass index = 30.0 ± 5.2 kg/m 2 ), and 9 women who were scheduled for bariatric surgery (body mass index = 44.1 ± 4.0 kg/m 2 ). BACs were estimated from breath samples and measured by gas chromatography at various times after consuming approximately 2 standard drinks. Results: BAC increased faster, peak BAC was approximately 2-fold higher, and feelings of drunkenness were heightened in both SG and RYGB groups relative to the presurgery group (P values<.001). BAC estimated from breath samples underestimated BAC by 27% (standard deviation = 13%) and missed peak BACs postsurgery. Conclusions: SG, similar to RYGB, causes marked alterations in the response to alcohol ingestion manifested by a faster and higher peak BAC. The breathalyzer is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol.

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KW - Metabolic surgery

KW - Pharmacokinetics

KW - Sleeve gastrectomy

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