Wednesday, November 7, 2018

Alcohol Consumption After Gastric Sleeve Surgery



Post bariatric surgery, have you too observed that alcohol affects you differently? While you were comfortable with having 2-3 pegs of your favourite Scotch before you went under the knife, now, even one peg make you feel the same as 2-3?
You can take a moment to find some solace in the fact that you are not the only one to feel so!

A survey found that nearly 90 per cent of patients who underwent either gastric bypass or gastric sleeve now find themselves more sensitive to alcohol. They, just like you, are able to feel the effects of alcohol after taking a few sips. Many also claimed that they lose muscle coordination after one or two drinks, and are not able to regain balance even after two-three hours.

If you think there is something wrong with bariatric surgery, let us assure you that it is only a myth. It is important to understand that the body undergoes many changes post bariatric surgery and in the end it all comes down to how the body absorbs alcohol and metabolizes it in a bariatric patient.

When you drink alcohol, or any alcoholic beverage with a normal gut anatomy, it first enters the stomach and gets metabolizes through the process called gastric alcohol metabolism where the enzyme alcohol dehydrogenase works its magic. However, gender, age, medications, etc., can affect the blood alcohol levels and its effects here. Alcohol absorption is also dependent on the rate at which alcohol empties into the intestines. Another factor that affects the whole process is food. Having food in the stomach slows down the gastric emptying, and eventually reduces the rate of alcohol absorption by the intestines. Conversely, an empty stomach enhances absorption and also increases the risk for intoxication.

Almost 95 percent of the stomach is bypassed in patients who undergo gastric bypass, and this includes the pylorus. In such a condition, the alcohol directly passes from the stomach into the intestines, where it is rapidly absorbed by the intestines due to their larger surface area. Add to this the postoperative rule of not eating while drinking, and you can imagine the rate at which alcohol is absorbed in bariatric patients.

Moreover, liver too plays a role in metabolizing the alcohol entering the body. But, conditions relatively common among individuals with morbid obesity, such as steatosis and fatty liver disease, make the alcohol metabolism a bit more difficult. Furthermore, bariatric patients follow a low carbohydrate diet which means that they have a low amount of glycogen. When alcohol enters the body, it further depletes the body of glycogen and also reduces glucose homeostasis. This puts the bariatric patient at a higher risk of hypoglycaemia.

Although all this may sound scary to you, however, you just consult a bariatric surgeon before you plan on drinking alcohol again. A thorough understanding and a few precautions can help you enjoy your drink without affecting your health.




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