Gastric origin of the first-pass metabolism of ethanol in humans: Effect of gastrectomy

Caballería, Joan; Frezza, M; Hernández‐Muñoz, Rolando; DiPadova, Carlo; Korsten, Mark A.; Baraona, Enrique; Lieber, Charles S.

doi:10.1016/0016-5085(89)91691-0

Cited by 153 publications

(70 citation statements)

References 13 publications

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“…36 Young women also appear to have lower first-pass metabolism of alcohol than young men, [37][38][39][40][41][42] and many investigators conclude that this gender difference in young nonalcoholic subjects results primarily from lower gastric alcohol metabolism in women. 37,38,43 However, gender differences in metabolism have not been consistently demonstrated, and the overall importance of gastric and hepatic first-pass metabolism of alcohol is still debated. 35,[44][45][46][47][48][49][50][51][52] Postmenopausal Estrogen Levels.…”

Section: Biological Plausibility Of Gender Differencesmentioning

confidence: 99%

Medical risks for women who drink alcohol

et al. 1998

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OBJECTIVE:To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women.METHODS: MEDLINE and PsychINFO, 1990 through 1996, were searched using key words "women" or "woman," and "alcohol." MEDLINE was also searched for other specific topics and authors from 1980 through 1996. Data were extracted and reviewed regarding levels of alcohol consumption associated with mortality, cardiovascular disease, alcoholrelated liver disease, injury, osteoporosis, neurologic symptoms, psychiatric comorbidity, fetal alcohol syndrome, spontaneous abortion, infertility, menstrual symptoms, breast cancer, and gynecologic malignancies. Gender-specific data from cohort studies of general population or large clinical samples are primarily reviewed. MAIN RESULTS:Women develop many alcohol-related medical problems at lower levels of consumption than men, probably reflecting women's lower total body water, gender differences in alcohol metabolism, and effects of alcohol on postmenopausal estrogen levels. Mortality and breast cancer are increased in women who report drinking more than two drinks daily. Higher levels of alcohol consumption by women are associated with increased menstrual symptoms, hypertension, and stroke. Women who drink heavily also appear to have increased infertility and spontaneous abortion. Adverse fetal effects occur after variable amounts of alcohol consumption, making any alcohol use during pregnancy potentially harmful. CONCLUSIONS:In general, advising nonpregnant women who drink alcohol to have fewer than two drinks daily is strongly supported by the epidemiologic literature, although specific recommendations for a particular woman should depend on her medical history and risk factors. L ess than three quarters of women in the UnitedStates drink alcohol, and those who do drink consume fewer drinks and less absolute alcohol than men. 1 However, at similar levels of self-reported alcohol consumption, the risk of psychosocial problems or dependence is greater for women than men (for definitions, see Appendix A). [2][3][4][5][6] Women also appear to develop alcohol abuse and dependence after fewer years of drinking than men. 7 Although only 4% to 5% of women in the U.S. general population meet criteria for past-year alcohol abuse or dependence, 8,9 9% of female primary care patients in some studies have reported recent heavy drinking or alcohol-related problems. 10,11 Many heavy drinkers decrease consumption following brief interventions that include explicit advice about safe drinking limits. [12][13][14] In addition, offering feedback about specific risks or consequences of their drinking to patients who drink heavily can help motivate them to decrease alcohol consumption or seek treatment. 15,16 Physicians report they would be more likely to advise patients about safe drinking practices if they were more confident of their knowledge about safe levels of alcohol consumption. 17 Women who drink more than two drinks daily on average, or who frequently drink five or more d...

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Section: Biological Plausibility Of Gender Differencesmentioning

confidence: 99%

Medical risks for women who drink alcohol

et al. 1998

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“…Another possible mechanism that can contribute to an increased alcohol exposure is the decreased contact with gastric mucosa and thereby to the action of gastric alcohol dehydrogenase after RYGB. In a study on patients after total gastrectomy compared with controls, gastric alcohol dehydrogenase proved to be responsible for a significant part of the first pass metabolism of alcohol [32].…”

Section: Discussionmentioning

confidence: 99%

Alcohol Consumption in Obese Patients Before and After Gastric Bypass as Assessed with the Alcohol Marker Phosphatidylethanol (PEth)

Walther

Brodén²,

Isaksson

et al. 2018

OBES SURG

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Introduction Roux-en-Y gastric bypass (RYGB) causes more rapid and enhanced absorption of alcohol. RYGB patients have also been reported to use more inpatient care for alcohol-related disease than do patients after other bariatric procedures. The present study was designed to evaluate alcohol consumption level before and after gastric bypass using a sensitive and specific alcohol biomarker. Materials and Methods Two separate consecutive groups of patients and a group of healthy blood donors, as reference group, were included in the study. Alcohol intake was assessed using the alcohol marker phosphatidylethanol (PEth) at preoperative baseline and at 1 and 2 years postoperatively. In the first patient group (n = 133), neither surgeon nor patient was informed about the results of PEth testing. In the second group (n = 214), PEth results above 0.30 μmol/L were considered to indicate excessive alcohol consumption and led to preoperative alcohol counseling. The groups were followed for 2 and 1 year, respectively. Results PEth results were significantly lower in both patient groups at baseline as well as postoperatively compared with the reference group. In both patient groups, there was a significant increase in PEth values at postoperative follow-up compared to baseline. Conclusions Several physiological changes postoperatively have to be considered when interpreting PEth results in obese patients with dramatic weight reductions. According to results for PEth, obese patients treated with bariatric surgery would seem to have lower alcohol consumption compared with the reference group. Although slightly increasing their PEth values postoperatively, the RYGB patients did not reach the PEth values of the reference group.

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“…The rate of absorption of alcohol is highly variable depending on food intake, gender, 3 and first-pass metabolism. 4 When the metabolic rate for alcohol is lower it results in raised blood alcohol levels and increased cerebral impairment.…”

Section: Alcohol Metabolismmentioning

confidence: 99%

Alcohol-related road traffic accidents: promoting a lower alcohol strategy

Marks

Williams

2007

Clinical Medicine

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-Impairment is the result of unpredictable genetic variation, coexisting disease, or drug interaction, and is modified by hepatic metabolism. The introduction of alcohol tsars and alcohol health workers in trauma centres would capitalise on the 'teachable moment' (when the conceptual link between drinking and its consequences can be demonstrated at a time when the consequences are obvious) to prevent recurring injuries and to lower alcohol intake. Accident fatalities have reached a plateau and the only way of reducing them further is to lower the European legal limit of blood alcohol concentration to a harmonised 50 mg/100 ml.

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Gastric origin of the first-pass metabolism of ethanol in humans: Effect of gastrectomy

Cited by 153 publications

References 13 publications

Medical risks for women who drink alcohol

Medical risks for women who drink alcohol

Alcohol Consumption in Obese Patients Before and After Gastric Bypass as Assessed with the Alcohol Marker Phosphatidylethanol (PEth)

Alcohol-related road traffic accidents: promoting a lower alcohol strategy

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