title: Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial.
abstract: BACKGROUND
  Severe obesity remains the leading public health crisis of the industrialized world, with bariatric surgery the only effective and enduring treatment. Poor psychological adjustment has been occasionally reported postoperatively. In addition, evidence suggests that patients can metabolize alcohol differently after gastric bypass.
  
  
  METHODS
  Preoperatively and at 3 and 6 months postoperatively, 19 Roux-en-Y gastric bypass (RYGB) patients' breath alcohol content (BAC) was measured every 5 minutes after drinking 5 oz red wine to determine peak BAC and time until sober in a case-crossover design preoperatively and at 6 months postoperatively.
  
  
  RESULTS
  Patients reported symptoms experienced when intoxicated and answered a questionnaire of drinking habits. The peak BAC in patients after RYGB was considerably higher at 3 months (0.059%) and 6 months (0.088%) postoperatively than matched preoperative levels (0.024%). Patients also took considerably more time to return to sober at 3 months (61 minutes) and 6 months (88 minutes) than preoperatively (49 minutes). Postoperative intoxication was associated with lower levels of diaphoresis, flushing, and hyperactivity and higher levels of dizziness, warmth, and double vision. Postoperative patients reported drinking considerably less alcohol, fewer preferred beer, and more preferred wine than before surgery.
  
  
  CONCLUSIONS
  This is the first study to match preoperative and postoperative alcohol metabolism in gastric bypass patients. Post-RYGB patients have much higher peak BAC after ingesting alcohol and require more time to become sober. Patients who drink alcohol after gastric bypass surgery should exercise caution.
authors.affiliation: Department of Surgery, Section of Minimally Invasive and BariatricSurgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Gavitt A
authors.initials: GA
authors.lastname: Woodard
authors.forename: John
authors.initials: J
authors.lastname: Downey
authors.forename: Tina
authors.initials: T
authors.lastname: Hernandez-Boussard
authors.forename: John M
authors.initials: JM
authors.lastname: Morton
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D000435:Alcoholic Intoxication / Q000175:diagnosis* / Q000378:metabolism; D015992:Body Mass Index; D001944:Breath Tests; D016022:Case-Control Studies; D002492:Central Nervous System Depressants / Q000009:adverse effects / Q000378:metabolism*; D000431:Ethanol / Q000009:adverse effects / Q000378:metabolism*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D011184:Postoperative Period; D057234:Preoperative Period; D011795:Surveys and Questionnaires
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol