GASTRECTOMY ENHANCES VULNERABILITY TO THE DEVELOPMENT OF ALCOHOLISM

A history of gastrectomy was more frequently encountered in Japanese m ale alcoholics (9.7%, 47/486) than in male employee populations of two large companies (0.8%, 36/4,381, p < 0.001, and 0.6%, 6/950, p < 0.00 1). Gastrectomized men are known to achieve a higher blood ethanol lev el after the ingestion of the equal amount of ethanol than nongastrect omized men. To examine whether or not gastrectomy was responsible for the subsequent development of alcohol dependence, 47 gastrectomized al coholics were compared with 47 age-matched nongastrectomized alcoholic s. The mean lifetime duration of heavy drinking (> 120 g ethanol/day) was shorter in the former than in the latter (11 +/- 10 years vs. 16 /- 9, p < 0.05), and the mean lifetime cumulative ethanol consumption level also smaller (834 +/- 497 kg vs. 1047 +/- 508, p < 0.05). The ma jority of gastrectomized patients (30/47) had no history of problem dr inking before gastrectomy. The daily consumption was rapidly increased within 5 years after gastrectomy in 18 of 38 habitual drinkers (47%). Seven of the remaining nine nonhabitual drinkers (78%) became habitua l drinkers and alcoholics within a short period of time (7 +/- 4 years ), though with low lifetime cumulative consumption (< 400 kg). The inc idence of disorders of the central and peripheral nervous systems obse rved did not differ between the two groups, except for frequent alcoho lic blackouts reported in the gastrectomized patients. In conclusion, the majority of the gastrectomized patients changed their drinking hab its after gastrectomy and developed alcohol dependence. They did not r equire as much lifetime cumulative ethanol as nongastrectomized patien ts to become ethanol dependent.