Neurotensin, Vasoactive Intestinal Peptide, and Roux-en-Y Gastrojejunostomy: Their Role in the Dumping Syndrome
Abstract
This study evaluated the effect of gastric bypass on the glucose, insulin, vasoactive intestinal peptide (VIP), neurotensin, and motilin response to orally administered glucose in eight morbidly obese patients before and after operation. Preoperatively, all eight patients remained asymptomatic during an oral glucose tolerance test, which showed glucose intolerance and hyperinsulinism. Plasma VIP, neurotensin, and motilin remained below detectable levels for the entire test. At three months following gastric bypass (21% weight loss), all eight patients became acutely ill during a repeated oral glucose tolerance test and had the following symptoms: facial flushing (eight patients), palpitations (eight patients), nausea (seven patients), abdominal fullness (seven patients), pallor (four patients), diaphoresis (two patients), vomiting (two patients), and diarrhea (two patients). Significant release of neurotensin occurred in seven patients while three patients had release of VIP, further implicating these two peptides as part of the pathophysiologic spectrum of the "dumping syndrome."
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Neurotensin and vasoactive intestinal polypeptide induce splanchnic vasodilation that results in hypotension and systemic hemoconcentration.
“Enhanced release of these GI hormones may induce discoordinated GI motility and inhibit secretion, as well as elicit hemodynamic effects; for example, neurotensin and vasoactive intestinal polypeptide induce splanchnic vasodilation that results in hypotension and systemic hemoconcentration (27).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [27]
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“Enhanced release of these GI hormones may induce discoordinated GI motility and inhibit secretion, as well as elicit hemodynamic effects; for example, neurotensin and vasoactive intestinal polypeptide induce splanchnic vasodilation that results in hypotension and systemic hemoconcentration (27).”
BackgroundInternational consensus on the diagnosis and management of dumping syndrome
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- Authors
- Sirinek, K. R.
- Corresponding author
- Sirinek, Kenneth R.
- Venue
- Archives of Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 1985-05-01
- Volume
- 120
- Issue
- 5
- Pages
- 605
- ISSN
- 0004-0010 (ISSN-L)
- OpenAlex
- W1981776752
- Cited by
- 41
- References
- 0
- Citations by year
- 2025: 1 · 2023: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (RR-01346)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- neurotensin, vasoactive intestinal peptide, Roux-en-Y gastrojejunostomy, gastric bypass, morbid obesity, dumping syndrome, postprandial hypoglycemia, hyperinsulinism, impaired glucose tolerance, motilin, postoperative complications, weight loss
- MeSH terms
- Adult, Blood Glucose, Dumping Syndrome, Female, Glucose Tolerance Test, Humans, Jejunum, Male, Neurotensin, Obesity, Postoperative Complications, Stomach, Vasoactive Intestinal Peptide
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