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Gastric Bypass And Alcohol Abuse Risk

 

Gastric bypass alcohol addiction  
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Gastric bypass: who and how?

Gastric bypass surgery is a common bariatric operation performed for people with excessive weight in order to reduce it. To be more precise, for people who have body mass index of 40 or 35-40 if they have diabetes, high blood pressure which can be corrected or even reversed after procedure.

There are 3 ways to do gastric bypass: to make stomach smaller, to shorten small intestine or to do both. In the first case, less food will make you satisfied and day after day you will lose weight. In the second case, nutrients which are in your diet will not be absorbed and less of them will be deposited in fat. Finally, the third way is a combination of foregoing cases.

Risk of alcohol abuse

As other surgical procedures gastric bypass has early and late complications such as leak of anastomosis, infection of incision site, anastomotic ulcer or stricture, anemia, B12 deficiency and psychological challenges. This list should be expanded with one more risk – alcohol addiction. It is most controversial and epidemiologically important complication because the use of gastric bypass operation as a weight loss tool should not suggest that it makes you an alcoholic.

After gastric bypass operation, technically known as Roux-en-Y, standardized amount of alcohol gives higher concentrations in the patient’s blood compared with people, who have not undergone this procedure. Besides, the alcohol effect is felt much faster and it lasts longer. Moreover, doctors do not exclude the theory of addiction shifting. After bariatric operation, a patient has to make changes in his diet, sometimes it is so unbearable that addiction for food is redirected to other things such as sex, smoking and alcohol.

According to the study, which questioned 2000 people who had gastric bypass operation in the USA, the risk of becoming addicted to alcohol is 30% higher compared to people after other bariatric procedures.

Patients were asked to indicate whether they had a difficulty to stop drinking after a couple of drinks, whether they could not remember what happened on drinking episode or whether they were in the need of a drink in the morning. If the patient confirmed one of these symptoms, he was considered as one with dependency on alcohol. The survey showed that 7, 6 % of patients had problems with alcohol (dependence) before the procedure, a year after- 7,3%, after two years this number climbed to 9,6%. Besides, 5, 5% had alcoholism symptoms. While 5 % patients confirmed abuse of alcohol after gastric binding procedure. This number slightly differs before and after surgery. It is because during this operation a special band is placed around the stomach which does not interfere with the surface and the way food goes from stomach to small intestine.

There are other factors that influence the results including young age, male sex, smoking, and alcohol abuse or taking drugs in the past and social life. While the aspects such as body mass index, the lost weight after gastric bypass procedure, mental and psychological state have no influence on the risk of alcohol abuse. So the need of psychological assessment before this surgical procedure is doubtful. However, it can be helpful to determine whether patient has any drug dependence, including alcohol, or not, but sometimes the understanding of dependence is different from one that doctor has in mind. This makes it hard to detect first alarm signals and prevent this problem.

Tendencies

It may seem that the risk of alcohol abuse after gastric bypass surgery is quite small, only 2%, but knowing that the problem of obesity is growing exponentially, more bariatric operations will be performed, more cases with potential risk factors will be overlooked and more complications will occur.

As mentioned above these patients have short small intestine which is responsible for the main fermentation and absorption of food, so in a short time mineral and vitamin status will be perverted. Liver function will be affected. It will happen shortly because usually patients with obesity have health problems before undergoing the surgery.

For now principal step in preventing the problem of dependency on alcohol associated with gastric bypass is precise screening. However, no one can deny that patient’s motivation has great impact- to be free of any addictions.