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March 17, 2006

Alcohol and Gastric Bypass

Alcohol A recent study reported in the British Journal of Clinical Pharmacology found that the gastric bypass procedure significantly affects alcohol absorption and its inebriating influence. According to the study protocol, a group of gastric bypass patients, three years post-surgery, and their non-surgical controls consumed an alcoholic drink containing 20% v/v alcohol (95% ethanol), and blood alcohol levels were examined over a period of time. The data showed that blood alcohol levels of the gastric bypass patients were far higher and required much less time to peak than those of the non-surgical controls.

The more rapid absorption of alcohol and heightened blood alcohol levels would cause the bariatric patient to have a more pronounced feeling of inebriation during and shortly after drinking.

Alcohol2_1 Why would alcohol absorption be higher for someone who has had gastric bypass? With the gastric bypass procedure, 95% of the stomach and the upper gut (duodenum and a portion of the jejunum) are bypassed. Alcohol passes directly from the stomach pouch, usually without restriction, into the second portion of the gut, known as the jejunum. This portion of the gut has a large surface area and readily and rapidly absorbs the alcohol.

In addition to anatomical changes in the tract that influence alcohol absorption, the gastric bypass patient may also be more sensitive to the intoxicating effects of alcohol because of the reduced calorie intake that occurs after surgery. A number of studies have found that alcohol absorption is far higher if fasting or when consumed on an empty stomach than if provided with a meal or drank soon thereafter.

Drinking alcohol in the early postoperative period may have other adverse effects on health. Frequent vomiting, low calorie intake, not taking multivitamins and malabsorption may cause a number of vitamin and mineral deficits, including thiamin.

Addiction transfer is yet another precaution to be considered with regard to alcohol. The prevalence of food addiction and associated eating abnormalities, i.e. binge eating, carbohydrate cravings, are high among individuals with morbid obesity. With bariatric surgery, the addictive tendencies for food and aberrant eating behavior are considerably improved. However, individuals with addictions often transfer their addiction to yet another substance, such as alcohol. According to the findings of one study, addiction transfer may occur in up to 25% of bariatric patients.

Drinking alcohol after surgery may also reduce maximal weight loss success. Alcohol has no nutrient benefits and contains high numbers of calories that may cause weight gain or prevent weight loss. One 12-ounce can of beer, for instance, contains 150 calories; 3.5 ounces of wine contains 70 calories; 1.5 ounces of gin, rum, vodka or whiskey contains between 97 and 124 calories; and 1.5 ounces of liquor contains 160 calories.

The bariatric patient should absolutely NOT drink alcohol during the rapid weight loss period and definitely not if consuming no or low carbohydrates, not taking vitamin and mineral supplements, vomiting frequently, or not able to keep their food down. However, with time, there is no reason an individual should not be able to enjoy an occasional drink, provided they are aware that it only takes a small amount of alcohol to produce an inebriating effect. With such knowledge, appropriate precautions should be taken, such as waiting a sufficient length of time after drinking to drive or perform other skilled tasks.

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Comments

I can relate with everyone who is going through this situation with GB . When I was getting ready to have my surgery Six years ago and my doctor firmly told me not to drink ever again
and I ask him why he told me just don't
it. Now I think about it. I feel like it is more about this surgery is not been told

ALH

Wow, to read all of these postings is amazing. I am 4 years post-op and although a social drinker before, I always new when to stop, but now I can't, I want a drink on a daily basis. Prior to surgery I was a beer drinker, now since the carbonation of beer makes me full, I switched to wine and can drink a whole bottle in one night. Definitely addition transfer. I'm scared !!

Sharon

I have two children that had the surgery. The last four years have been a nightmare. They both are very sick with alcoholism. My daughter has been in rehab,has lost jobs and now I'm raising her 6 yr old son. My son has 3 DUI and most likely will go to jail this week, which might save his life.The extremes they go thru to get there bottle is beyond anyones
comprehension. They were told not to drink before the surgery but tried to continue their social life
afterwards. They get so intoxicated they can't remember anything and no one wants to be around them anymore. There not kids,44 and 46 yrs old. This is the worst thing they could have done.

Jenny

I'm scheduled for surgery in 4 days. Some co-workers mentioned addiction transfer to me yesterday. It was the first I had heard of it, and being in the medical field I had thought myself very well informed. I usually have a beer or two at night 5 nights a week. I don't get drunk, I don't even really get "buzzed". After reading this, I'm afraid of ever drinking again. I don't want to lose my job, which I would if I ever got a DUI or came in to work reeking of alcohol fumes. If you never take that first I'll-just-try-and-see-what-happens drink, is it possible to resist the cravings. I'm worried because of lot of the respondents have said they did not drink before and now they "crave" alcohol. I'm miserable with my weight and have worked hard to get this surgery but I don't want to ruin my life worse than it is now.

gtfo

I went from 450 to 205. DS/BPD. Then divorce, foreclosure, DUI .13, and closing in on a chapter 7. Divorce was needed and resulted in the foreclosure. At 2 1/2 yrs post op I reverted back to the days of my youth and commenced to partying again like a rockstar, Got hooked on Pain meds, survived and now doing the right thing again. Its been a hell of a ride. Weight is 215 to 220 and at 6'3" I'm happy, now 4 years post-op.

Mike

Amazing, It sounds like we are all going through similar issues if we drink. I think a lot of it is that our bodies have changed so much, I know that loosing 150lbs and looking great after 30 years of feeling so dejected, it's like wow a little drink loosen's me up to talk to people whom would of rejected me years before, I think it's a self esteem issue for me. Problem is that like others the 1 leads to two then problems. I have committed to never put the stuff to my lips again, after tearing my sons room completely apart after drinking and going over his poor report card. Oh the same might driving my brand new nissan 350z over rail road tracks without a road. Something has to give. I love life and this has to stop.
God is big and with his help I will conquer it.
Peace. [email protected] if you want to talk.

Melissa

I am 5 years post-op GBS and went to rehab, quit for two months and went back to drinking. I can drink and not have a hangover. I never had an issue with alcohol ever in my past it is hard to understand the transfer addiction thing but I guess it has happened to me. I almost got divorced, moved several times, became very permiscuois, and almost died as a result of drinking and taking sleeping pills. If I would have known the effects from this surgery I would have rather died from obesity..

Melissa

I am 5 years post-op GBS and went to rehab, quit for two months and went back to drinking. I can drink and not have a hangover. I never had an issue with alcohol ever in my past it is hard to understand the transfer addiction thing but I guess it has happened to me. I almost got divorced, moved several times, became very permiscuois, and almost died as a result of drinking and taking sleeping pills. If I would have known the effects from this surgery I would have rather died from obesity..

Carole

Reading most of these entries surprises me---not the addiction substitution,as I was aware that that could happen, but just that I think someone should address the possible medical complications of alcohol abuse and GBP surgery. I am 8 years post op-never drank much to begin with and always are the designated driver so I don't consume now, but I have lost a friend who had the surgery and who, besides being able to consume much more than I post op, she also drank and could tolerate more than other post ops. She died from what we know had something to do with her liver, and if I remember correctly, everything you eat or drink, 1/2 calories are not absorbed but what does get absorbed is more direct. I would think that maybe the alcohol gets a more direct line to the liver and the liver has to filter out the toxins. I wonder if there is any information ouyt there on the liver damage from alcohol use in gastric bypass patients.

Miram lucas

Hi everyone it's been 5mnths since i've had my surgery i've lost 80 plus pounds. But now I feel like im at a stand i started drinking on the 8-23-08 and i haven't stopped yet,in fact I think I'm gaining some of my weight back please help what to do!!!!

Tammy

Hi everyone. There seems to be some similiarities in these posts right? No one drank before surgery, everyone is drinking primarily wine, having blackouts, etc. I read that perhaps there is an allergic reaction when drinking wine that can affect us greatly! I rarely drank before surgery, maybe once or twice a year and never wine. Even now, I only drink wine on the weekends but once I start I can't stop (I don't even try) and I always blackout and remember nothing the next day. My boyfriend says I turn into another person when I get drunk and it is like I have a split personality and I get very mean and hurtful. I have to believe him because I have absolutely no recollection of the night before after the first few glasses of wine. I'm not sure what's going on, but I am ready to seek professional help before I destroy my relationship. I lost almost 200lbs after surgery and have gained back 50. I need to get a grip! It never gets easy for us does it?

lauren

I am glad as well to read your comments. I had a gastric Bypass (Roux-en-y) 4 years ag0 . My wonderful family is upset with me and my 22 year old daughter is calling me an "alcoholic" now after one glass of wine I may have....I feel so babdly about this, work, and do not drink heavily but do love white wine . any advice..
Thanks for listening all of you .
Lauren
Berkeley, Ca.

lauren

I am glad as well to read your comments. I had a gastric Bypass (Roux-en-y) 4 years ag0 . My wonderful family is upset with me and my 22 year old daughter is calling me an "alcoholic" now after one glass of wine I may have....I feel so babdly about this, work, and do not drink heavily but do love white wine . any advice..
Thanks for listening all of you .
Lauren
Berkeley, Ca.

Lora

Im post op 4 years now. I,m having blackouts everytime I drink. I used to enjoy drinking, now It's just scary . I get pretty mean toward my poor husband.

Sheri

I would rather be fat than dealing with addiction. Had I known what it would cost me, I would not have had the surgrey

Judy

I had GP 6 yrs ago. I am expeeriencing everything that have been included in the blogs, rapid absorption of wine, etc. it is not safe to continue drinking after this surgery or even begin, if you were a "social" drinker before! AA is the only program that has helped so far on this slippery slope into alcoholism...

Bob

I am 2yrs post op and discovered very quickly that it took just a small amount of alcohol to make a big, but short lived effect. My biggest problem is that my spouse absolutely detests alcohol so I have to "sneak" my alcohol use. This makes me feel very guilty, but I have gotten to the point where I need the alcohol to sleep. I do not drink during the day, only at night to fall asleep. Like many on the other posts, I sometimes don't remember falling asleep or how much I actually drank. Very scary! Another problem is medications. You have to specify "timed release" or "controlled release" medications to your doctor. For example, I was taking a generic sleeping pill to help with getting to sleep-it absolutely did not work. I would sleep for 2 hours and then be up! I talked my doc into controlled release version and it made a difference. Gastric Bypass was a positive and life-changing event for me. But like many of you, I am worried about my growing dependance on alcohol. Let's all pray for each other.

bab

how do i stop drinking gbp patient march 2008 drinking has become a very big problem?

Sara

I'm only a month post op, would it be a ridiculously bad idea to sip at a drink over a period of time at this point?

Christina

I am post op nearly 3 years now and my alcohol consumption has increased dramatically. I have not gained any weight, but I am having a drink nearly every night, wine or calvados.I guess it does effect me quicker, but I don't suffer hangovers. I am just worried that this will cause my liver or kidney to give me problems at some point, but somehow can't stop either.

Wanda Lafferty

Wow, As I read all these comments I can't stop my tears. My husband had the surgery only 3 months ago and he craves alcohol more than ever. He is struggling to eat anything, he lost 105 pound in the three months (330 - 225) I'm really worried about him and it scares me. He is a very nice person but this is affecting our marriage and family. Is very disapointing because we thought this surgery was going to change our lives for the good and now he traded an addiction to another. 25% of the time he is being drunk and when I said drunk I talked about one bottle of Hennessy per night. Before he could not drink half of that. I feel he's killing himself and I dont' know what to do. Can someone give advice on how can I help him to cope with this situation before it's too late. Please e-mail me with facts and advice. ([email protected]) Thanks.

Brandon123

Well, I am sorry about all of those who are experiencing drinking problems post-op, but I just need to know if I do this surgery, can I still drink a moderate amount?? Of coarse calories and vitamins are a serious factor, but I am already aware of that! Please tell me if lap band or GBP is the better choice for a moderate drinker. I need to know so that I can make my decision, and at one time I lost 40lbs. on low-carb while still having a few drinks. Please advise directly. thx, Brandon

Darren


people please relax about this, it does not happen to everyone. my new addiction is shirts ;-) god i look great going from xxx large to a small in 8 months

jay

I can relate to the alcohol issue. I had 3 beers in 4hrs and got a dui and i blew a .09. people we all need to be careful if you drink. Our bodies are different now and drinking can offset all the pain and suffering we all went through to lose the weight. Just be Careful!
Jay

Rebecca

PLEASE READ THIS! My brother just passed away in April of 2009. He was status post gastric bypass of a few years. He became an alcoholic shortly afterwards. he did drink prior to his surgery but this evil had grabbed a hold of him and would not let go. Let me say that all the evidence and research on this subject is true. I would totally avoid drinking all together or limit yourself to one or two glasses of whatever but nothing more. My brother went into the hospital with severe abdominal pain, he was observed by the ER physician who wanted him to be transferred to a Pittsburgh Hospital since his labs were extremely elevated. We were told that this was his first case of "pancreatitis. he started to have the withdraw symptoms which are life threatening. he had agreed to stay after signing himself out of the hospital because the pain and the withdraw symptoms were too much to bear. the next day he was intubated and never talked again. he went through several surgeries, having a colostomy placed, his stomach was exposed since they did not want to close the wound for they might have to go back in and do more surgery. after all this was done to him he died at the age of 42. he was so talented with art and playing the guitar, so smart he could fix anything and so funny. I miss him so much. I wanted him to get to better and perhaps maybe should of been a little more aggressive with that, but he did not believe his problem was that bad. When I was cleaning out his closet in his bedroom I discovered 16 empty bottles of black velvet. My heart sank and I knew right there what kind of "hell" he was going through. So when you decide you want to have gastric by pass, you must realize that it is a total life change, not only with food but with drinking. the physicians tell you for a reason that this can be detrimental to your health. Most people do the gastric by pass as a quick fix to lose weight and think that they can eat and drink whatever they want, but you can't. One other note, if you have an addicted personality I strongly recommend going through therapy before gastric by pass. I am a gastric by pass patient too and work in the medical field and hear so many stories.

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