A silhouette of a man resting his head on his hand which holds a glass of whiskey. There is a bottle of whiskey on the table.

Bariatric surgery can boost unhealthy drinking relationships after surgery, according to a study by military veterans.

In a retrospective analysis of data from the U.S. Department of Veterans Affairs, veterans who did not have an unhealthy relationship with alcohol two years before laparoscopic gastrectomy were more likely to use alcohol unhealthily eight years after surgery than those who did not. Supervisors (7.9% vs. 4.5%, difference 3.4%, 95% CI 1.8-5.0), said Matthew Machieski, MD, MD, MD, North Carolina.

According to a similar pattern, veterans who did not have alcohol-related problems two years before Roux-en-Y gastric bypass surgery (RYGB) were more likely to develop an unhealthy drinking relationship eight years later than non-surgical controls (9.2% vs. 4). 4%): difference 4.8%, 95% CI 3.6-5.9), they noted Open JAMA network.

In both procedures, patients saw an increase in the prevalence of unhealthy drinking throughout the postoperative years.

“From these findings, we estimate that for every 21 patients who are exposed [RYGB] և Every 29 patients who are exposed [laparoscopic sleeve gastrectomy]”On average, one in each group will develop unhealthy alcohol use,” Machesky said, adding that “the risks associated with alcohol have been somewhat more pronounced since: [RYGB] than: [laparoscopic sleeve gastrectomy]which potentially reflects greater changes in RYGB-related alcohol pharmacokinetics. ”

Veterans who have undergone this or that type of bariatric surgery are also less likely to abstain completely from alcohol for 5 to 8 years after surgery compared to non-surgical supervision.

And 8 years after acute gastrectomy, about 10% of patients (95% CI -13.1% -6.4%) are less likely to abstain from non-surgical alcohol control than those who underwent RYGB. , about 8% (95% CI -10.1%): up to -5.9%) are less likely to be non-drinkers.

Average scores on the Alcohol Identification Disorder (AUDIT-C) scale also rose after two types of bariatric surgery, but not for surgical comparators.

In a smaller sample of unhealthy alcohol use before surgery, RYGB patients were 13% more likely to continue using that unhealthy alcohol 8 years after surgery than non-surgical controls.

The retrospective cohort study included 1,539 veterans who underwent a digital gastrectomy of 14,555 non-surgical patients, as well as 854 patients who underwent gastric bypass, compared with 8,038 non-surgical patients, none of whom reported alcohol. unhealthy use in the beginning. All surgical patients underwent their bariatric surgery at one of the 130 bariatric centers of the VA Health System from 2008 to 2016. Unlike other bariatric groups, this group consisted of 75% of men.

Anne Fernandez, a doctor at the University of Michigan at Ann Arbor, called the study a “well-designed study” and said that unhealthy alcohol use is often overlooked in bariatric surgery studies and ultimately an “iatrogenic complication of bariatric surgery.” procedures. “

He explained that “bariatric surgical procedures are a crossroads where one group of patients goes from one common, high-risk behavior to another, which is an iatrogenic product that affects patients, families, and society.” In fact, obesity is the underlying behavior of unhealthy alcohol. “Drug use (ie, physical inactivity, poor diet, alcohol use) are the leading causes of preventable death in the United States.”

Fernandez added that these findings enhance the need for preoperative և postoperative alcohol education և counseling, but noted that preoperative alcohol screening is not particularly useful in this scenario, as Maciejewski’s team found that patients with both types of surgery reduce alcohol consumption immediately. their procedure.

Instead, he suggested that health care providers create, for example, flags in these patients’ electronic health records (EHRs) to monitor their alcohol-related problems for years after surgery.

The limitations of the study included the complete reliance on alcohol screening through the VA EHR system, so unhealthy alcohol consumption may be underestimated. “Because patients who consume unhealthy alcohol are often not admitted for bariatric surgery, self-report can be biased,” the authors note.

  • Kristen Monaco is a staff writer focusing on endocrinology, psychiatry and dermatology news. Outside of New York, he has worked for the company for about five years.

Discoveries:

The study was funded by the National Institute on Drug Abuse (NIDA), VA, Durham VA Center for Detection և Practice Acceleration Transformation Innovation և George H.A. The Closes Career Development Award from the American College of Surgeons. մրցանակ Career Development Award.

Maciejewski revealed a related relationship with NIDA և Amgen. The authors co-sponsored the NIH, NIDA, the Patient Outcome Research Institute, VA, and the American College of Surgeons. One of the co-authors identified a related relationship with the International Federation of Obesity and Metabolic Surgery – World Latin American Congress on Diabetes Intervention Therapy. One co-author discovered that it serves as: HOURS: Deputy Editor.

Fernandez revealed support for the National Institute on Alcohol Abuse, the Alcoholism Institute, and the relationship with the Michigan Department of Health and Human Services Contracts.

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