Gastric Bypass & Alcohol Abuse

Researchers from the University at Buffalo Research Institute on Addictions in collaboration with the Penn State College of Medicine are investigating why a significant percentage of people who opt for a gastric bypass procedure for weight loss develop alcohol abuse problems.

The researchers plan to focus their study on the possible neurological causes for the increased vunerability for alcohol use disorders in this group of people.Senior research scientist; Dr Panayotis K Thanos stated: “Recent findings have shown the risk of developing an alcohol use disorder following gastric bypass surgery was nearly double the risk in the general population. Although other studies have shown the risk to be not quite that high, the numbers all point to the need for greater research in this area.”

Dr Thanos added; “Most alcohol use disorders manifest during a person’s teens or 20’s. However, people who have a gastric bypass tend to be older, so the alcohol abuse arises at a much later onset date than in the general population.” So this likelihood of developing alcohol problems is unusual because of the older age of the patients.

Alcohol

Results of the study could prove valuable to clinicians when they formulate personalised post operative treatment plans for patients who may already have an increased risk of alcohol use disorders, in order to help prevent develoment of the addiction.

Dr Thanos concluded; “We will explore whether this outcome is due to changes in the brain’s dopamine system that are a unique result of the gastric bypass surgery, and independent of weight loss or post surgical change of diet.  Such a change in the dopamine system may increase preference for an intake of alcohol based on its increased rewarding effects in the brain. This, in turn, poses an increased risk for development of addiction.”

Reference: Bariatric News Issue 28

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Side Effects Of Bariatric Surgery

Side Effects of Bariatric Surgery

Bariatric surgery is a procedure performed on obese individuals in order to help them achieve rapid weight loss. The risks associated with bariatric surgery fall into two main categories: those related to restricted food intake and rapid weight loss and those associated with the surgical procedure itself.

Accordingly, side effects can be categorized as:

hospital-IV

Immediate post-operative complications

  • Infection of the wound and of the operative site (affects around 1 in 20 patients)
  • Internal bleeding (occurs in around 1 in 100 patients)
  • Development of blood clots (occurs in around 1 in 100 patients). Clots may develop in leg veins (deep vein thrombosis) or travel up to the lungs causing a pulmonary embolism, which can be life threatening.

Death

The immediate complications of bariatric surgery can result in a patient’s death. Pulmonary embolism, severe bleeding, major infection, stroke, or heart attack are all conditions that put the patient’s life at serious risk. The estimated risk of death after gastric band insertion is around 1 in 200 and after the gastric bypass the risk is around 1 in 100.

Factors that raise the risk of dying due to post-operative complications include age, male gender, high blood pressure, increased risk for pulmonary embolism and a body mass index of 50 or above. Risks for pulmonary embolism include a history of pulmonary hypertension, deep vein thrombosis, and blood clots.

Development of gallstones

Gallbladder

Gall bladder stones are a common outcome of bariatric surgery, with stones developing in around 1 in 12 individuals. Gallstones are aggregates of chemicals and cholesterol that eventually clog up the gall bladder. The stones may be symptomless or may cause intense pain in the abdomen as well as nausea, vomiting and jaundice.

Stoma blockage

Stoma blockage is a common complication of gastric bypass surgery that occurs when the opening (stoma) that connects the stomach pouch to the small intestine becomes blocked by a piece of food, resulting in persistent vomiting. The condition occurs in around one-fifth of patients and is treated by directing a small flexible tube called an endoscope into the stoma where a balloon attached to the endoscope is inflated to remove the obstruction. To avoid stoma blockage, food must always be taken in small bites and chewed thoroughly.

Excess skin

excess skin

 

Rapid weight loss among obese individuals results in skin becoming excessively loose and folded. Folds of skin are most typically acquired around the breasts, back, abdomen, limbs, and hips and are normally most apparent 12 to 18 months after surgery. The folds can be unsightly and may harbour moisture leading to infections and rashes. These excess skin flaps can be removed and the skin tightened using cosmetic surgery.

 

Effects on mental health

Rapid weight loss may have a detrimental effect on mental health, with many patients suffering from depression and anxiety after surgery. Patients may also develop relationship problems with their partner. Additionally, social occasions orientated around meals may make the patient feel isolated and anxious due to their much reduced appetite and restricted diet.

Slippage of the gastric bandband slippage

Gastric band slippage is a problem that affects around 1 in 50 patients who have had an adjustable band fitted. The band slips out of position and the stomach pouch becomes bigger than it should be, resulting in nausea, vomiting and heartburn. It is not life threatening but further surgery could be required to repair the slippage.

 

Intolerance to foods

Food intolerance occurs in around 1 in 35 patients who have had bariatric surgery and may develop years after the procedure. Foods such as red meat may bring on heartburn, nausea and vomiting.

 

Reference:

By Dr Ananya Mandal, MD

Reviewed by Sally Robertson, BSc

 

Source News Medical