Should WLS Post-Ops Drink Alcohol After Surgery?
July 15, 2016Should WLS post-ops drink alcohol after surgery? Unlike many of the questions that we have about the changes that happen to the body after bariatric surgery, there is some reasonably good data regarding alcohol’s effect on the post-bariatric patient.
We have the most information regarding alcohol intake after RNY Gastric Bypass. The effects of alcohol are less clear after Sleeve Gastrectomy or Gastric Banding but are still worrisome enough to warrant extreme caution with alcohol intake after any kind of bariatric surgery.
In reviewing the literature on alcohol use after bariatric surgery, it is obvious that there are still more questions than answers, but a few gems come to light in the research that we do have.
Post-ops and Alcohol After Surgery
In a nutshell, it comes down to this: In a patient who has had Gastric Bypass, blood alcohol levels rise much faster after drinking, they peak at least two times as high, and it takes much longer than pre-surgical patients for the blood alcohol levels to return to zero.
For example, in one study performed at Stanford, 19 patients who had Gastric Bypass were tested before surgery, at three months after surgery, and at six months after surgery. These patients were given 5 ounces of red wine to drink, and then blood alcohol content (BAC) was measured at time intervals until the alcohol was completely cleared from the system.
The findings were astonishing. Prior to surgery, the average BAC after a glass of wine was 0.024%. However, in the SAME individuals six months after surgery the average peak BAC skyrocketed to 0.088%. That’s over the legal limit for driving in the United States with just one standard drink of alcohol.
Another interesting finding in this and other studies like it are that the BAC hits its peak much faster than pre-op patients (10 minutes versus 30 minutes in one study!). And while the blood alcohol levels rise much quicker, the alcohol actually stays in the system much longer in a post-bariatric surgery individual than you would see in someone who hasn’t had bariatric surgery.
Be Careful of Your Alcohol Intake
Knowing this information, you might be able to imagine why someone who might have a tendency towards abuse alcohol prior to surgery may be at much higher risk for alcohol use disorder after surgery. Actual studies on the prevalence of alcohol use disorder are conflicting, but it is very clear that one has to be very careful with alcohol intake after surgery. (Anecdotally speaking, I have seen this become a serious concern for some patients.)
Apart from the fact that alcohol intake after bariatric surgery can be downright dangerous, there are other good reasons to avoid imbibing in the future. Consider the significant amount of calories a drink a day would add to the post-bariatric surgery diet. A glass of red wine contains around 120 calories, so drinking one glass of wine every evening would add almost 10% more calories per day to the average post-bariatric surgery patient. Now, the mechanics of energy storage are extremely complex and probably beyond our current understanding, but if you only stored half of those 100 extra calories per day it would lead to putting on 5 pounds per year. Alcohol intake generally will add unwanted (and essentially “empty”) calories to your daily budget.
Be Kind to Your Stomach!
One last reason to avoid alcohol: be kind to your stomach! According to my unscientific Google search, the same alcohol we drink (ethanol) is also used in varnishes, perfumes, gasoline additives, and solvents, among other things. That same chemical that can fuel your commute to work will cause irritation of the stomach lining when taken orally even in modest quantities at times. One of the common presentations of a “marginal ulcer” after gastric bypass is in someone who has been drinking excessively.
At the risk of beating a dead horse, for those of you who have had bariatric surgery, please be extremely cautious with alcohol intake. Never drive or perform other similar activities even after taking very small quantities. Plan for a much longer time to become sober than you were used to in the past. And for many patients, you may want to avoid alcohol altogether for all of the reasons listed above.
 | ABOUT THE AUTHOR Dr. Benjamin Shadle is the Medical Director for Bariatric Surgery at Sutter Roseville Medical Center and continues his dream of helping his patients achieve healthier and happier lives through bariatric surgery and impacting the health of families for the better. He understands that obesity, diabetes, hypertension and other related diseases can have a tremendous negative impact on a patient's health and quality of life as well as family members.Read more articles by Dr. Shadle! |
