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

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.