Alcoholism in patients submitted to bariatric surgery: notes on transfer of compulsion
DOI:
https://doi.org/10.25118/2763-9037.2022.v12.281Keywords:
Alcoholism, Bariatric surgery, substance-related disordersAbstract
Introduction: Throughout the psychiatric clinical experience, we come across many patients who, after surgical treatment for obesity, develop alcohol-related disorders. This leads us to question the existence or not of a compulsion transference mechanism, what was once an eating disorder becomes an addictive disorder. Objective: To investigate the association of alcoholism in patients undergoing bariatric surgery. Method: Literature review of scientific productions in the textual modality of articles, indexed in the database MEDLINE, through the free search tool PUBMED, carried out in June 2021, using the keywords selected according to the Medical Subject Headings: alcoholism, bariatric surgery, substance use, drug use, addiction. Seven publications were eligible for this study. Results: The reviewed studies showed converging results in the association between patients undergoing bariatric surgery and alcoholism. Although the techniques may be different, alcohol-related disorders seem to be more related to the Roux-en-Y gastric bypass technique. Conclusions: Alcoholism in patients undergoing bariatric surgery is associated with postoperative medical complications. We must take into account the importance of the need to identify patients at risk for such problems, ideally before surgery. The reviewed data suggest that both Roux-en-Y Gastric Bypass and Gastric Sleeve surgery dramatically affect the pharmacokinetics of alcohol and cause a probable transfer of binge (food X alcohol) involving the mesolimbic dopaminergic pathway reward system. We should recommend that high-risk patients or patients with Roux-en-Y Gastric Bypass surgery) abstain from alcohol use after bariatric surgery due to altered alcohol metabolism, as well as the potential for alcohol use disorders after surgery.
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