Alcohol ingestion symptoms after sleeve gastrectomy: intoxication or drunkenness? A prospective study from a Bariatric C
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ORIGINAL ARTICLE
Alcohol ingestion symptoms after sleeve gastrectomy: intoxication or drunkenness? A prospective study from a Bariatric Centre of Excellence Angelo Iossa1 · Maria Chiara Ciccioriccio1 · Chiara Zerbinati2 · Anna Guida1 · Liliana Di Giacomo3 · Gianfranco Silecchia1 Received: 17 September 2019 / Accepted: 30 October 2019 © Springer Nature Switzerland AG 2019
Abstract Purpose The aim of this original research is to evaluate the effect of SG on alcohol intake symptoms, blood alcohol content (BAC), and alcohol metabolite levels. Methods At 0–6–12 months after SG, BAC of patients was measured at 0, 15, 30, and 60 min, and then every 30 min, and urinary metabolite (ethanol and acetaldehyde) levels were measured 2 h after consuming a standard red wine drink. Symptoms perceived by patients were evaluated using symptom alcoholization post-obesity surgery scores. Results Thirty obese patients (12 men/18 women; mean body mass index, 44 ± 4 kg/m2) who underwent SG were enrolled in this study. At 12 months after SG, no alcohol use disorder was observed and BAC tended to peak after 15 min, with alcohol intoxication symptoms (nausea/vomiting, flushing, and diaphoresis), and return to zero after 90 min of wine intake. Ethanol and acetaldehyde levels were significantly different at 12 months compared with the levels at time 0 (p 25 kg/m2] and 9.8% is obese (BMI > 30 kg/m2) [1]. Bariatric surgery is the most * Angelo Iossa [email protected] 1
Division of General Surgery and Bariatric Centre of Excellence, Department of Medical‑Surgical Sciences and Biotechnologies, University of Rome “La Sapienza”, Rome, Italy
2
Biochemistry, Researcher of Department of Medicine and Pharmacy, University of Rome “La Sapienza”, Rome, Italy
3
Head of Clinical Pathology Department, Santa Maria Goretti Hospital, Latina, Italy
effective long-term treatment for morbid obesity [2, 3]. As per the last International Federation for the Surgery of Obesity (IFSO) report, sleeve gastrectomy (SG) is the most frequently performed primary surgical bariatric/metabolic procedure (N = 340,550; 53.6%), followed by Roux-en-Y gastric bypass (RYGB) (N = 191,326; 30.1%) [4]. SG is a safe and effective long-term procedure that imparts metabolic effects due to diet restriction as well as neurobehavioral effects due to changes in ghrelin and glucagon-like peptide-1 level [5, 6]. It induces postoperative changes in the patient’s appetite, taste, smell, and food preferences, which contribute to the long-term reduction in energy intake [7]. Bariatric surgery has been reported as increased risk of alcohol abuse with an effect mediated by gut hormones, change in taste and preference, and genetic and social factors [8, 9], particularly after gastric bypass surgery [10, 11]. For this reason, the American Society for Metabolic and Bariatric Surgery issued a position statement on alcohol consumption [12] with a warning about substance abuse after bariatric surgery. The statement reports no conclusive data after SG because of the
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