Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 27;16(3):650-657.
doi: 10.4240/wjgs.v16.i3.650.

Alcohol associated liver disease and bariatric surgery: Current perspectives and future directions

Katherine M Cooper  1 , Alessandro Colletta  2 , Nicholas Hebda  2 , Deepika Devuni  2   3
Affiliations
Review

Alcohol associated liver disease and bariatric surgery: Current perspectives and future directions

Katherine M Cooper et al. World J Gastrointest Surg. .

Abstract

Bariatric surgery is a routinely performed procedure and is associated with a reduction in all-cause mortality in patients with obesity. However, bariatric surgery has also been linked to increased alcohol use with up to 30% of these patients developing alcohol use disorder (AUD). The mechanism of AUD after bariatric surgery is multifactorial and includes anatomic, metabolic, and neurohumoral changes associated with post-surgical anatomy. These patients are at increased risk of alcohol associated liver disease and, in some cases, require liver transplantation. In this article, we provide a scoping review of epidemiology, pathophysiology, and clinical outcomes of alcohol-related health conditions after bariatric surgery.

Keywords: Alcohol use disorder; Liver transplant; Obesity medicine; Roux-en-Y gastric bypass; Simultaneous liver transplant and bariatric surgery; Vertical sleeve gastrectomy.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: Deepika Devuni has received grant funding from Sequana Medical for a clinical trial unrelated to the present work and grant funding from the NIAAA for research unrelated to this work. All other authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Mechanisms of alcohol related liver disease after bariatric surgery. Several anatomic, metabolic, and neurohumoral changes occur after bariatric surgery. A: Changes in the gastric anatomy affect the metabolism and pharmacokinetics properties of alcohol and lead to enhanced alcohol sensitivity and reduced tolerance; B: These alterations are linked to changes in brain reward pathways that can increase the risk of developing alcohol use disorders; C: Further, reduced first pass metabolism results in increased delivery of alcohol to the liver; D: Together, these may result in earlier onset alcohol associated liver injury and chronic alcohol associated liver disease. MASLD: Metabolic dysfunction-associated steatotic liver disease; BAC: Blood alcohol concentration; GHSR, or ghrelin receptor: Growth hormone secretagogue receptor; RYGB: Roux-en-Y gastric bypass. Image created using Biorender.com.
See this image and copyright information in PMC

References

    1. Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, Scopinaro N. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27:2279–2289. - PMC - PubMed
    1. Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis. PLoS Med. 2020;17:e1003206. - PMC - PubMed
    1. Ivezaj V, Benoit SC, Davis J, Engel S, Lloret-Linares C, Mitchell JE, Pepino MY, Rogers AM, Steffen K, Sogg S. Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms. Curr Psychiatry Rep. 2019;21:85. - PMC - PubMed
    1. Mellinger JL, Shedden K, Winder GS, Fernandez AC, Lee BP, Waljee J, Fontana R, Volk ML, Blow FC, Lok ASF. Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse. Liver Int. 2021;41:1012–1019. - PMC - PubMed
    1. Chierici A, Alromayan M, DEFATICO S, Céline D, Vinci D, Rodolphe A, Schiavo L, Iannelli A. Is bariatric surgery safer before, during, or after liver transplantation? A systematic review and meta-analysis. J Liver Transpl. 2023;9:100139.