Pathophysiology, diagnosis and management of postoperative dumping syndrome
Abstract
Dumping syndrome is a frequent complication of esophageal, gastric or bariatric surgery. Rapid gastric emptying, with the delivery to the small intestine of a significant proportion of solid food as large particles that are difficult to digest, is a key event in the pathogenesis of this syndrome. This occurrence causes a shift of fluid from the intravascular component to the intestinal lumen, which results in cardiovascular symptoms, release of several gastrointestinal and pancreatic hormones and late postprandial hypoglycemia. Early dumping symptoms comprise both gastrointestinal and vasomotor symptoms. Late dumping symptoms are the result of reactive hypoglycemia. Besides the assessment of clinical alertness and endoscopic or radiological imaging, a modified oral glucose tolerance test might help to establish a diagnosis. The first step in treating dumping syndrome is the introduction of dietary measures. Acarbose can be added to these measures for patients with hypoglycemia, whereas several studies advocate guar gum or pectin to slow gastric emptying. Somatostatin analogs are the most effective medical therapy for dumping syndrome, and a slow-release preparation is the treatment of choice. In patients with treatment-refractory dumping syndrome, surgical reintervention or continuous enteral feeding can be considered, but the outcomes of such approaches are variable.
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Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia.
“Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms.
“Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Alterations in gastric anatomy or interference with its intrinsic innervation disturb gastric emptying mechanisms and allow a substantial amount of undigested food to reach the small intestine too rapidly.
“Alterations in gastric anatomy or interference with its intrinsic innervation disturb gastric emptying mechanisms and allow a substantial amount of undigested food to reach the small intestine too rapidly (1,2).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Hypoglycemia-related symptoms are related to neuroglycopenia (fatigue, weakness, confusion, hunger and syncope) and autonomic/adrenergic reactivity (perspiration, palpitations, tremor and irritability).
“Hypoglycemia-related symptoms are related to neuroglycopenia (fatigue, weakness, confusion, hunger and syncope) and autonomic/adrenergic reactivity (perspiration, palpitations, tremor and irritability) (1,2).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Gastric surgery reduces gastric volume or removes the barrier function of the pylorus, resulting in the rapid delivery of a substantial amount of undigested solid food to the small intestine, thereby bypassing the larger part of the stomach.
“Gastric surgery reduces gastric volume or removes the barrier function of the pylorus, resulting in the rapid delivery of a substantial amount of undigested solid food to the small intestine, thereby bypassing the larger part of the stomach (Fig. 1) (1).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Dumping syndrome is not a single disease entity but consists of a constellation of symptoms that can be categorized as early dumping or late dumping symptoms.
“Dumping syndrome is not a single disease entity but, instead, consists of a constellation of symptoms that can be categorized as early dumping or late dumping symptoms (1,2).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Early dumping is characterized by gastrointestinal symptoms such as abdominal pain, bloating, borborygmi, nausea, and diarrhoea, and vasomotor symptoms such as fatigue, desire to lie down after meals, flushing, palpitations, perspiration, tachycardia, hypotension, and, rarely, syncope.
“Early dumping is characterized by gastrointestinal (GI) symptoms such as abdominal pain, bloating, borborygmi, nausea, and diarrhoea, and vasomotor symptoms such as fatigue, desire to lie down after meals, flushing, palpitations, perspiration, tachycardia, hypotension, and, rarely, syncope (1,2).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Test results are positive for late dumping based on the development of late (60-180 min postingestion) hypoglycemia.
“Test results are positive for late dumping based on the development of late (60-180 min postingestion) hypoglycemia (1).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
The OGTT is considered positive for early dumping based on the presence of an early (30 min) increase in haematocrit >3% or an increase in pulse rate >10 beats/min after 30 min, the latter being regarded as the most sensitive indicator of early dumping syndrome.
“The OGTT is considered positive for early dumping based on the presence of an early (30 min) increase in haematocrit >3% or an increase in pulse rate >10 beats/min after 30 min, the latter being regarded as the most sensitive indicator of early dumping syndrome (1).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Patients with dumping syndrome who receive long-term somatostatin analogue therapy experience a weight gain of approximately 1% despite generally mild steatorrhea.
“Despite the occurrence of steatorrhea, which is generally mild, patients with dumping syndrome who receive long-term somatostatin analogue therapy experience a weight gain of approximately 1% (1).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Anecdotal evidence suggests that continuous enteral feeding may be beneficial in avoiding dumping symptoms after meal ingestion; however, this approach is invasive and may impair quality of life.
“Anecdotal evidence suggests that continuous enteral feeding may be beneficial in avoiding dumping symptoms after meal ingestion; however, this approach is invasive and may impair quality of life (1,126).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [1]
Late dumping syndrome involves an incretin-driven hyperinsulinemic response to undigested carbohydrates that can result in a hypoglycemic episode.
“An incretin-driven hyperinsulinemic response to undigested carbohydrates can result in a hypoglycemic episode [ 12 , 13 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [12]
Cites
Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery.
Service, G. J., Thompson, G. B., Service, F. J., Andrews, J. C., Collazo-Clavell, M. L., & Lloyd, R. V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043690 · Cited by 779 · see citing works
Patti, M. E., McMahon, G., Mun, E. C., Bitton, A., Holst, J. J., Goldsmith, J., Hanto, D. W., Callery, M., Arky, R., Nose, V., et al. (2005) · Diabetologia · doi:10.1007/s00125-005-1933-x · Cited by 365 · see citing works
Esophageal Resection for Cancer of the Esophagus: Long-Term Function and Quality of Life
McLarty, A. J., Deschamps, C., Trastek, V. F., Allen, M. S., Pairolero, P. C., & Harmsen, W. S. (1997) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(97)00125-2 · Cited by 272 · see citing works
Meier, J. J., Butler, A. E., Galasso, R., & Butler, P. C. (2006) · Diabetes Care · doi:10.2337/dc06-0392 · Cited by 249 · see citing works
Impaired gastric accommodation and its role in dyspepsia
Kindt, S., & Tack, J. F. (2006) · Gut · doi:10.1136/gut.2005.085365 · Cited by 221 · see citing works
Self-citationLetter: The handicapped family.
Caplan, M. B., & Antonis, P. (1975) · PubMed · Cited by 194 · see citing works
Relationship between symptoms and ingestion of a meal in functional dyspepsia
Bisschops, R., Karamanolis, G. P., Arts, J., Caenepeel, P., Verbeke, K., Janssens, J., & Tack, J. F. (2008) · Gut · doi:10.1136/gut.2007.137125 · Cited by 187 · see citing works
Self-citationSigstad, H. (1970) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1970.tb08072.x · Cited by 176 · see citing works
MacGregor, I., Parent, J., & Meyer, J. H. (1977) · Gastroenterology · doi:10.1016/s0016-5085(77)80072-3 · Cited by 163 · see citing works
Sigstad, H. (1970) · PubMed · Cited by 152 · see citing works
Arts, J., Caenepeel, P., Bisschops, R., Dewulf, D., Holvoet, L., Piessevaux, H., Bourgeois, S., Sifrim, D., Janssens, J., & Tack, J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.11.025 · Cited by 142 · see citing works
Self-citationGastrointestinal Complications of Bariatric Surgery: Diagnosis and Therapy
Abell, T. L., & Minocha, A. (2006) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200604000-00008 · Cited by 136 · see citing works
Moreira, R. O., Moreira, R., Machado, N., Gonçalves, T. B., & Coutinho, W. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9569-9 · Cited by 136 · see citing works
Exaggerated secretion of glucagon-like peptide-1 (GLP-1) could cause reactive hypoglycaemia
Toft-Nielsen, M., Madsbad, S., & Holst, J. J. (1998) · Diabetologia · doi:10.1007/s001250051049 · Cited by 132 · see citing works
Jenkins, D. J. A., Gassull, M. A., Leeds, A. R., Metz, G., Dilawari, J. B., Slavin, B., & Blendis, L. M. (1977) · Gastroenterology · doi:10.1016/s0016-5085(19)32189-4 · Cited by 124 · see citing works
Differential regional effects of octreotide on human gastrointestinal motor function.
von der Ohe, M. R., Camilleri, M., Thomforde, G. M., et al. (1995) · Gut · doi:10.1136/gut.36.5.743 · Cited by 106 · see citing works
THE CAUSE AND TREATMENT OF CERTAIN UNFAVORABLE AFTER-EFFECTS OF GASTROENTEROSTOMY
Hertz, A. F. (1913) · Annals of Surgery · doi:10.1097/00000658-191310000-00004 · Cited by 102 · see citing works
(1997) · PubMed · Cited by 101 · see citing works
PECTIN IN THE DUMPING SYNDROME: REDUCTION OF SYMPTOMS AND PLASMA VOLUME CHANGES
LEEDS, A. (1981) · The Lancet · doi:10.1016/s0140-6736(81)92242-x · Cited by 100 · cited 4× · see citing works
“…et al. (1977)30 5 Pectin 14.5 g, single administration before OGTT Improved symptoms and glycemia (normalized in 46% of patients) during OGTT Leeds et al. (1981)31 11 Pectin 15 g, single administration before OGTT Improved vasomotor symptoms and glycemia, lower insulin levels and prolonged…”
BackgroundInfluentialEfficacy of Octreotide Acetate in Treatment of Severe Postgastrectomy Dumping Syndrome
Geer, R. J., Richards, W. O., O’Dorisio, T. M., WOLTERING, E. O., Williams, S. T., Rice, D. E., & Abumrad, N. N. (1990) · Annals of Surgery · doi:10.1097/00000658-199012000-00005 · Cited by 99 · see citing works
Parkinson, C., Drake, W. M., Roberts, M. E., Meeran, K. M., BESSER, G. M., & Trainer, P. J. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.4.8432 · Cited by 90 · see citing works
Fuessl, H. S., Carolan, G., Williams, G., & Bloom, S. R. (2009) · Digestion · doi:10.1159/000199407 · Cited by 89 · see citing works
Effect of a somatostatin analogue on gastric motor and sensory functions in healthy humans
Foxx–Orenstein, A. E., Camilleri, M., Stephens, D. A., & Burton, D. D. (2003) · Gut · doi:10.1136/gut.52.11.1555 · Cited by 88 · see citing works
Delayed Gastric Emptying of Liquids and Solids Following Roux-en-Y Billiary Diversion
Hocking, M. P., Vogel, S. B., Falasca, C. A., et al. (1981) · Annals of Surgery · doi:10.1097/00000658-198110000-00012 · Cited by 83 · see citing works
Diagnostic Value of Dumping Provocation in Patients after Gastric Surgery
Van Der Kleij, F. G. H., Vecht, J., Lamers, C. B. H. W., & Masclee, A. A. M. (1996) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365529609036905 · Cited by 83 · see citing works
Treatment of the Dumping Syndrome with the Somatostatin Analogue SMS 201–995
Hopman, W. P. M., Wolberink, R. G. J., Lamers, C. B. H. W., & Van Tongeren, J. H. M. (1988) · Annals of Surgery · doi:10.1097/00000658-198802000-00007 · Cited by 79 · see citing works
Moschetta, A., Stolk, M. F. J., Rehfeld, J. F., Portincasa, P., Slee, P. H. T. J., Koppeschaar, H. P. F., Van Erpecum, K. J., & Vanberge‐Henegouwen, G. P. (2001) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2001.00924.x · Cited by 79 · cited 1× · see citing works
“Gallstone formation is not an uncommon complication of the long-term use of somatostatin analogs and should be taken into account when considering treatment options for dumping syndrome”
BackgroundGut Hormone Profile and Gastric Emptying in the Dumping Syndrome
Lawaetz, O., Blackburn, A. M., Bloom, S. R., Arıtaş, Y., & Ralphs, D. N. L. (1983) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528309181562 · Cited by 73 · see citing works
Effect of pectin on gastric emptying and gut hormone release in the dumping syndrome.
Lawaetz, O., Blackburn, A., Bloom, S., Aritas, Y., & Ralphs, D. (1983) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528309181602 · Cited by 70 · see citing works
Van Maercke, Y. (1961) · PubMed · Cited by 65 · see citing works
Effect of sequential erythromycin and octreotide on antroduodenal manometry.
Lorenzo, C. D., Lucanto, C., Flores, A., Idries, S., & Hyman, P. (1999) · Journal of Pediatric Gastroenterology and Nutrition - JPGN · doi:10.1097/00005176-199909000-00010 · Cited by 64 · see citing works
Tack, J. (2007) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2007.04.001 · Cited by 63 · cited 1× · see citing works
“disclosures; (2) study the education content; (3) take the post‐test”
BackgroundSelf-citationLong‐term results of octreotide‐therapy in severe dumping syndrome
Vecht, J., Lamers, C., & Masclee, A. (1999) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1999.00819.x · Cited by 61 · see citing works
A GLYCOSIDE-HYDROLASE INHIBITOR IN TREATMENT OF DUMPING SYNDROME
McLoughlin, J. C., Buchanan, K. D., & Alam, M. J. (1979) · The Lancet · doi:10.1016/s0140-6736(79)91665-9 · Cited by 59 · see citing works
Acarbose treatment of postprandial hypoglycemia in children after Nissen fundoplication
Ng, D. D., Ferry, R. J., Kelly, A., Weinzimer, S. A., Stanley, C. A., & Katz, L. E. L. (2001) · The Journal of Pediatrics · doi:10.1067/mpd.2001.119169 · Cited by 53 · see citing works
Octreotide therapy in dumping syndrome: analysis of long‐term results
Didden, P., Penning, C., & Masclee, A. (2006) · Alimentary Pharmacology and Therapeutics · doi:10.1111/j.1365-2036.2006.03124.x · Cited by 52 · see citing works
Henegouwen, M. I. V. B., van Gulik, T. M., Akkermans, L. M. A., et al. (1997) · Gut · doi:10.1136/gut.41.6.758 · Cited by 51 · see citing works
Somatostatin and the dumping syndrome.
Long, R., Adrian, T. E., & Bloom, S. R. (1985) · BMJ · doi:10.1136/bmj.290.6472.886 · Cited by 50 · see citing works
Efficacy of depot long‐acting release octreotide therapy in severe dumping syndrome
PENNING, C., VECHT, J., & MASCLEE, A. A. M. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02681.x · Cited by 48 · see citing works
Results of Laparoscopic Antireflux Procedures in Neurologically Impaired Children
Pimpalwar, A., & Najmaldin, A. (2002) · Seminars in Laparoscopic Surgery · doi:10.1177/155335060200900312 · Cited by 47 · see citing works
Postprandial Effects of SMS 201-995 on Gut Hormones and Glucose Tolerance
Williams, G. H., Fuessl, H., KRAENZLIN, M. E., & Bloom, S. R. (1986) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528609087434 · Cited by 45 · see citing works
Clinical and radionuclide evaluation of Roux-Y diversion for postgastrectomy dumping
Vogel, S. B., Hocking, M. P., & Woodward, E. R. (1988) · The American Journal of Surgery · doi:10.1016/s0002-9610(88)80258-7 · Cited by 44 · see citing works
Superiority of Antiperistaltic jejunal Segments in Management of Severe Dumping Syndrome
Sawyers, J., & HERRINGTON, I. L. (1973) · Annals of Surgery · doi:10.1097/00000658-197309000-00011 · Cited by 43 · see citing works
Mechanisms by which octreotide ameliorates symptoms in the dumping syndrome.
Hasler, W. L., Soudah, H. C., & Owyang, C. (1996) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)13083-8 · Cited by 43 · see citing works
Effect of Acarbose on Biochemical Responses and Clinical Symptoms in Dumping Syndrome
Lyons, T. J., McLoughlin, J. C., Shaw, C., et al. (2009) · Digestion · doi:10.1159/000199185 · Cited by 41 · see citing works
Sirinek, K. R. (1985) · Archives of Surgery · doi:10.1001/archsurg.1985.01390290083014 · Cited by 41 · see citing works
Effect of octreotide on gastric and small bowel motility in patients with gastroparesis
Edmunds, Chen, Soykan, Lin, & McCallum (1998) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.1998.00289.x · Cited by 41 · see citing works
Effect of long acting somatostatin-analogue, SMS 201995, on gut hormone secretion in normal subjects
KRAENZLIN, M. E., Wood, S. M., Neufeld, M., et al. (1985) · Cellular and Molecular Life Sciences · doi:10.1007/bf02012573 · Cited by 41 · see citing works
Mayer, E. A., Thomson, J., Jehn, D., Reedy, T., Elashoff, J., & Meyer, J. H. (1982) · Gastroenterology · doi:10.1016/0016-5085(82)90173-1 · Cited by 40 · see citing works
Primrose, J. N., & Johnston, D. (1989) · Journal of British Surgery · doi:10.1002/bjs.1800760212 · Cited by 40 · cited 1× · see citing works
“…symptoms and suppression of postprandial rise in pulse rate; reduced peak insulin and increased nadir glycemia; slowing of gastrointestinal transit Primrose & Johnston (1989)52 10 Octreotide 50 μg vs 100 μg vs placebo before OGTT Reduced early dumping and abolished late dumping symptoms;…”
BackgroundOctreotide acetate induces fasting small bowel motility in patients with dumping syndrome
Richards, W. O., Geer, R. J., O’Dorisio, T. M., et al. (1990) · Journal of Surgical Research · doi:10.1016/0022-4804(90)90172-x · Cited by 39 · see citing works
Control of dumping symptoms by somatostatin analogue in patients after gastric surgery.
Gray, J., Debas, H., & Mulvihill, S. (1991) · Archives of Surgery · doi:10.1001/archsurg.1991.01410340073010 · Cited by 39 · see citing works
Results of laparoscopic antireflux procedures in neurologically impaired children
Pimpalwar, A. P., & Najmaldin, A. (2002) · Seminars in Laparoscopic Surgery · doi:10.1053/slas.2002.126992 · Cited by 39 · see citing works
Acarbose in reactive hypoglycemia: a double-blind study.
Gérard, J., LUYCKX, A. S., & Lefèbvre, P. J. (1984) · PubMed · Cited by 38 · see citing works
Nelson‐Piercy, C., Hammond, P. J., Gwilliam, M. E., et al. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.78.2.7906279 · Cited by 37 · see citing works
Etiologic Significance of the Early Symptomatic Phase in the Dumping Syndrome
Johnson, L. P., Sloop, R. D., & Jesseph, J. E. (1962) · Annals of Surgery · doi:10.1097/00000658-196208000-00002 · Cited by 36 · see citing works
Nutritional manipulation in the management of dumping syndrome.
Khoshoo, V., Reifen, R. M., Gold, B. D., et al. (1991) · Archives of Disease in Childhood · doi:10.1136/adc.66.12.1447 · Cited by 36 · see citing works
Pyloric Reconstruction for Severe Vasomotor Dumping after Vagotomy and Pyloroplasty
Cheadle, W. G., BAKER, P. R., & Cuschieri, A. (1985) · Annals of Surgery · doi:10.1097/00000658-198511000-00006 · Cited by 34 · see citing works
Postprandial hypoglycemia after Nissen fundoplication for reflux esophagitis.
Zaloga, G., & Chernow, B. (1983) · Gastroenterology · doi:10.1016/0016-5085(83)90155-5 · Cited by 33 · see citing works
Efficacy of Guar Gum in Preventing the Dumping Syndrome
Harju, E., & Larmi, T. K. I. (1983) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607183007005470 · Cited by 33 · see citing works
Andersson, S., Jagner, S., Jaroszewski, J. W., et al. (1989) · Acta chemica Scandinavica/Acta chemica Scandinavica. B, Organic chemistry and biochemistry/Acta chemica Scandinavica. A, Physical and inorganic chemistry/Acta chemica Scandinavica. Series B. Organic chemistry and biochemistry/Acta chemica Scandinavica. Series A, Physical and inorganic chemistry · doi:10.3891/acta.chem.scand.43-0039 · Cited by 33 · see citing works
Long-term effect of α-glucosidase inhibitor on late dumping syndrome
Hasegawa, T., Yoneda, M., Nakamura, K., et al. (1998) · Journal of Gastroenterology and Hepatology · doi:10.1046/j.1440-1746.1998.01783.x · Cited by 32 · see citing works
Long acting somatostatin analogue in dumping syndrome
Tulassay, Z., Tulassay, T., Gupta, R., & Cierny, G. (1989) · Journal of British Surgery · doi:10.1002/bjs.1800761223 · Cited by 31 · see citing works
Kemmer, T. P., Malfertheiner, P., Büchler, M. W., et al. (1992) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.1992.tb00543.x · Cited by 28 · see citing works
Effect of octreotide on fluid absorption and secretion by the normal human jejunum and ileum in vivo
Högenauer, C., Aichbichler, B. W., Ana, C. S., Porter, J. L., & Fordtran, J. S. (2002) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2002.01228.x · Cited by 26 · see citing works
Effect of Guar Gum on Gastric Emptying after Gastric Resection
Harju, E., Heikkilä, J., & Larmi, T. K. I. (1984) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860718400800118 · Cited by 26 · see citing works
The use of jejunal interposition for intractable symptoms complicating peptic ulcer surgery
RAMUS, N. I., Williamson, R. C. N., & Johnston, D. A. (1982) · British journal of surgery · doi:10.1002/bjs.1800690512 · Cited by 25 · see citing works
EWINS, D., JAVAID, A., COSKERAN, P., SHAN, S., BUTLER, J., DEPREZ, P., MIELL, J., CALAM, J., BARRETT, J., DAWSON, J., et al. (1992) · QJM: An International Journal of Medicine · doi:10.1093/oxfordjournals.qjmed.a068669 · Cited by 25 · see citing works
The effect of somatostatin on dumping after gastric surgery: a preliminary report.
Reasbeck, P. G., & van Rij, A. M. (1986) · PubMed · Cited by 24 · see citing works
Dumping syndrome after Nissen fundoplication
VEIT, F., HEINE, R. G., & CATTO‐SMITH, A. G. (1994) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.1994.tb00607.x · Cited by 23 · see citing works
Dietary management of postgastrectomy dumping syndrome.
Fw, R., & Ac, P. (1957) · PubMed · Cited by 16 · see citing works
Jejunal Factor Stimulating Insulin Release in the Isolated Perfused Canine Pancreas and Jejunum
Eloy, R., Garaud, J., Moody, A., Jaeck, D., & Grenier, J. (1975) · Hormone and Metabolic Research · doi:10.1055/s-0028-1093704 · Cited by 14 · cited 1× · see citing works
“Under 'normal' conditions, the presence of glucose in the jejunum is a strong stimulus for insulin secretion; the rapid delivery of carbohydrates to the small intestine in dumping syndrome, therefore, causes excessive insulin secretion that subsequently results in hypoglycemia”
BackgroundThe Cause and Treatment of certain Unfavourable After-effects of Gastro-enterostomy
Hertz, A. F. (1913) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591571300601929 · Cited by 12 · see citing works
Andersen, J. R., Holtug, K., & Uhrenholt, A. (1989) · PubMed · Cited by 12 · see citing works
Reduction in symptoms after proximal selective vagotomy through increased dietary viscosity.
Harju, E., & Mäkelä, J. T. (1984) · PubMed · Cited by 12 · see citing works
Koruth, N. M., Krukowski, Z. H., & Matheson, N. A. (1985) · British journal of surgery · doi:10.1002/bjs.1800721012 · Cited by 11 · see citing works
Surgical treatment of the postgastrectomy dumping syndrome.
Woodward, E. R., Pl, D., & Gasster, M. (1955) · PubMed · Cited by 7 · see citing works
Mörz, R., Prager, J., & Pointner, H. (1982) · PubMed · Cited by 5 · see citing works
Dietary Management the “Dumping” Syndrome . Long-Term Follow-Up
Pittman, A. C., & Robinson, F. W. (1962) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(21)15754-2 · Cited by 5 · see citing works
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Sorted by citations
Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice
Sherf Dagan, S., Goldenshluger, A., Globus, I., Schweiger, C., Kessler, Y., Kowen Sandbank, G., Ben-Porat, T., & Sinai, T. (2017) · Advances in Nutrition · doi:10.3945/an.116.014258 · Cited by 348 · see citing works
Jacobsen, S. H., Olesen, S. C., Dirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Kielgast, U., Worm, D., Almdal, T., Naver, L. S., Hvolris, L. E., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0621-4 · Cited by 342 · see citing works
van Beek, A. P., Emous, M., Laville, M., & Tack, J. (2017) · Obesity Reviews · doi:10.1111/obr.12467 · Cited by 288 · see citing works
“The OGTT is considered positive for early dumping based on the presence of an early (30min) increase in haematocrit >3% or an increase in pulse rate >10 beats/min after 30min, the latter being regarded as the most sensitive indicator of early dumping syndrome (1).”
BackgroundInfluentialSelf-citationComplications of bariatric surgery: Dumping syndrome, reflux and vitamin deficiencies
Tack, J., & Deloose, E. (2014) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2014.07.010 · Cited by 181 · see citing works
Self-citationChanges in Eating Behaviour and Meal Pattern Following Roux-En-Y Gastric Bypass
Laurenius, A., Larsson, I., Bueter, M., Melanson, K. J., Bosaeus, I., Forslund, H. B., Lönroth, H., Fändriks, L., & Olbers, T. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.217 · Cited by 174 · see citing works
Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review
Abdeen, G., & le Roux, C. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1945-7 · Cited by 162 · see citing works
Lee, C. J., Clark, J. M., Schweitzer, M., Magnuson, T., Steele, K., Koerner, O., & Brown, T. T. (2015) · Obesity · doi:10.1002/oby.21042 · Cited by 159 · see citing works
“Also known as late dumping syndrome, postbariatric surgery hypoglycemia differs from the early dumping syndrome in its delayed onset of 1–2 hours after a meal without vasomotor symptoms (7).”
BackgroundTzovaras, G., Papamargaritis, D., Sioka, E., Zachari, E., Baloyiannis, I., Zacharoulis, D., & Koukoulis, G. (2012) · Obesity Surgery · doi:10.1007/s11695-011-0461-7 · Cited by 97 · see citing works
Medical Nutrition Therapy for Post-Bariatric Hypoglycemia: Practical Insights
Suhl, E., Anderson-Haynes, S.-E., Mulla, C., & Patti, M.-E. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.01.025 · Cited by 96 · see citing works
Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications
Hölzen, L., Schultes, B., Meyhöfer, S. M., & Meyhöfer, S. (2024) · Biomedicines · doi:10.3390/biomedicines12020391 · Cited by 44 · see citing works
Choung, R. S., Locke, G. R., Lee, R. M., Schleck, C. D., Zinsmeister, A. R., & Talley, N. J. (2012) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2011.01791.x · Cited by 42 · see citing works
Sheehan, A., & Patti, M. E. (2020) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s233078 · Cited by 39 · see citing works
Hypoglycemia after gastric bypass surgery
Singh, E., & Vella, A. (2012) · Diabetes Spectrum · doi:10.2337/diaspect.25.4.217 · Cited by 30 · see citing works
Change in Emotional Eating After Bariatric Surgery: Systematic Review and Meta-Analysis
Wong, L. Y., Zafari, N., Churilov, L., Stammers, L., Price, S., Ekinci, E. I., & Sumithran, P. (2020) · BJS Open · doi:10.1002/bjs5.50318 · Cited by 29 · see citing works
Basbug, A., Ellibeş Kaya, A., Dogan, S., Pehlivan, M., & Goynumer, G. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1471678 · Cited by 28 · see citing works
- Authors
- Tack, J., Arts, J., Caenepeel, P., De Wulf, D., & Bisschops, R.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- Tack, Jan
- Venue
- Nature Reviews Gastroenterology & Hepatology
- Published
- 2009-09-01
- Volume
- 6
- Issue
- 10
- Pages
- 583-590
- ISSN
- 1759-5045 (ISSN-L)
- 1759-5053
- OpenAlex
- W1997676087
- Cited by
- 387
- References
- 79
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 17 · 2023: 25 · 2022: 24 · 2021: 29 · 2020: 31 · 2019: 33 · 2018: 24 · 2017: 28 · 2016: 33 · 2015: 23 · 2014: 23 · 2013: 15 · 2012: 21
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- rapid gastric emptying, esophageal surgery complications, gastric surgery complications, bariatric surgery complications, postprandial hypoglycemia, acarbose, guar gum, pectin, somatostatin analogues, dietary management, reoperation, continuous enteral feeding
- MeSH terms
- Dumping Syndrome, Gastric Emptying, Humans, Hypoglycemia, Somatostatin, Digestive System Surgical Procedures, Vasomotor System, Acarbose
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