The Critical Role of the Rate of Ethanol Absorption in the Interpretation of Studies Purporting to Demonstrate Gastric Metabolism of Ethanol

The area under blood ethanol concentration-time curves may be lower after ingestion vs. intravenous infusion of similar ethanol doses, a difference that has been attributed to first-pass metab-olism in the gasthc mucosa. Using a model of human hepac ethanol metabolism, we predted the area under tood ethanol concentration-time curves and first-pass metabolism that would result from oral vs. Intravenous ethanol. This model accurately predicted reported differences in AUC after oral vs. intravenous ethanol. First-pass metabolism has been shown to disappear when the stomach is bypassed via intraduodenal or portal vein infusion of ethanol. Our model predts that the effidency of first-pass metabolism is extremely sensitive to the hepatic delivery rate of ethanol and the rapid ethanol delivery rate in bypass studs would have elimk’iated hepatic first-pass metabolism. We conclude that hepatic ethanol metabolism could explain pub