Dumping symptoms is triggered by fat as well as carbohydrates in patients operated with Roux-en-Y gastric bypass

• Background: Dumping syndrome after Roux-en-Y gastric bypass (RYGB) is traditionally associated with the consumption of refined carbohydrates, but the role of dietary fat is unclear. Objectives: This study compares symptoms after consumption of a carbohydrate-rich or fat-rich beverage to determine perceived symptoms, glycemic control, and pulse rate. Methods: We assessed perceived symptoms (Sigstad's Dumping Index) and glycemic control (P-glucose and S-insulin) as well as autonomic nervous system activity (reflected by arterial pulse rate) after a standardized liquid meal test (440 kcal/300 mL carbohydrates [CARB] or fat [FAT]) in a randomized crossover blinded setting. Blood samples were drawn before and 1, 15, 30, and 60 minutes after finishing each meal and the area under the curve (AUC) was calculated. Results: Twelve patients 42 +/- 10 months after undergoing RYGB were studied. AUC differed between drinks for glucose (P = .003) and insulin (P = .005). Pulse rate increased more after CARE than after FAT (P = .01). AUC for perceived symptoms in the Sigstad's Dumping Index were similar after meals (P = .79), yet the pattern of type of symptoms differed. Conclusion: In patients with RYGB, a meal with predominant fat content resulted in as much perceived dumping symptoms as a carbohydrate-profiled meal. As expected, an increase in glucose and insulin levels were found only after carbohydrate intake and the pulse rise was more pronounced for carbohydrates than fat. Dietary counseling in patients undergoing RYGB should address dietary fat as well as traditional information about carbohydrates to avoid dumping symptoms. (C) 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

Gastric bypass

Dumping syndrome

Dietary carbohydrates

Dietary fats

morbid-obesity

weight-loss

surgery

pathophysiology

complications

malabsorption

diagnosis

appetite

glucose

meal

Surgery

Publication and Content Type

ref (subject category)

art (subject category)