Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management

Beek, André P van; Emous, Marloes; Laville, Maurice; Tack, Jan

doi:10.1111/obr.12467

Cited by 227 publications

(240 citation statements)

References 119 publications

(221 reference statements)

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“…Possibly, the delay of autonomic and incretin hormones stimulations (once incretins also induce sympathetic and autonomic effects) may at least partly explain the improvement observed in early DS; in fact, increased release of multiple gastrointestinal hormones, including vasoactive agents, incretins, and glucose modulators, in early DS has been described 4,20–22…”

Section: Discussionmentioning

confidence: 99%

“…Current approaches for DS treatment comprise dietary recommendations3,4,6 such as small and frequent meals, inclusion of fiber and protein in every meal, and ingestion of guar gum and pectin. Pharmacological options for DS are limited and mostly symptomatic, such as tincture opium for diarrhea,7 meclizine, promethazine, and proton pump inhibitors 3,6.…”

Section: Introductionmentioning

confidence: 99%

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Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients

Cadegiani¹,

Silva²

2016

DMSO

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ObjectiveAcarbose is a glucosidase inhibitor that slows carbohydrate digestion. It could thus be effective to promote remission of dumping syndrome (DS). Previous studies associating acarbose and late dumping, although not early dumping, have been reported. Herein, we aimed to evaluate the role of acarbose in dumping syndrome prevention and treatment and in resistive exercises resistance in bariatric subjects.MethodsBariatric patients with DS and complete adherence to diet plan and resistive exercises were included (n=25). Number of early and late episodes, self-referred intensity of each episode, and ability to increase intensity of resistive exercise were evaluated, on a 0–10 scale. Acarbose was administered orally (50 mg) for 6 months, 4–5 times a day before meals.ResultsAcarbose administration was associated with a decrease in the number of early (2.18–0.31) and late (2.79–0.12) episodes per week and intensity of each episode (6.10–1.65) and an increase in the ability to perform resistive exercises (3.03–7.12). Complete remission of DS was seen in 21 patients (84%), which persisted for 6 months with the use of acarbose.ConclusionAcarbose prevented dumping in almost all studied subjects and helped improve exercise capacity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients

Cadegiani¹,

Silva²

2016

DMSO

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“…(19), what may be a caution against dumping (25). Inadequate calcium intake may contribute to impair bone homeostasis, due to increases in serum PTH and 1,25-dihydroxyvitamin D3 (1,25(OH) 2 D 3 ) (26), and a high sodium consumption may also compromises bone health (27,28).…”

Section: Discussionmentioning

confidence: 99%

Bone turnover after bariatric surgery

Melo

Froeder

Baia

et al. 2017

Arch. Endocrinol. Metab.

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Objective: The aim of the present study was to evaluate parameters of bone and mineral metabolism after bariatric surgery. Subjects and methods: This sectional study included data from medical records from 61 bariatric surgery (BS) patients (minimum period of 6 months after the procedure) and from 30 class II and III obese patients as a control group (Cont), consisting of daily dietary intake of macronutrients, calcium and sodium, serum 25(OH)D and parathyroid hormone (PTH) and other biochemical serum and urinary parameters. Bone alkaline phosphatase (BAP), leptin, fibroblast growth factor-23 (FGF-23) and deoxypyridinoline (DPYD) were determined from available banked serum and urinary samples. Results: Mean body mass index (BMI), median energy, carbohydrate, protein and sodium chloride consumption were significantly lower in the BS versus Cont, but calcium and lipids were not. No significant differences were found in ionized calcium, 25(OH)D, PTH and fibroblast growth factor 23 (FGF-23) between groups. Mean serum BAP was significantly higher for BS versus Cont and had a positive correlation with time after the surgical procedure. Mean serum leptin was significantly lower and median urinary DPYD higher in BS versus Cont. Conclusion: The present study showed an increase in bone markers of both bone formation and resorption among bariatric patients up to more than 7 years after the surgical procedure, suggesting that an increased bone turnover persists even at a very long-term follow-up in such patients. Arch Endocrinol Metab.2017;61(3):332-6.

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“…Initially described in 1913, it encompasses a loosely connected constellation of symptoms experienced after meals, with early symptoms being predominantly vasomotor and late symptoms related to reactive hypoglycaemia (7,8). Over 50% of 269 post-total gastrectomy patients complained of some dumping symptoms in a large Japanese study (9).…”

Section: Editorialmentioning

confidence: 99%

Decision making, quality of life and prophylactic gastrectomy in carriers of pathogenic CDH1 mutations

Roberts¹,

Hardwick²,

Fitzgerald³

2017

Transl. Gastroenterol. Hepatol.

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Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management

Abstract: SummaryBackground: Dumping syndrome, a common complication of esophageal, gas-

Cited by 227 publications

References 119 publications

Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients

Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients

Bone turnover after bariatric surgery

Decision making, quality of life and prophylactic gastrectomy in carriers of pathogenic CDH1 mutations

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