Abstract
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.
Setting
University hospital.
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 CARB 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.
Keywords
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Article info
Publication history
Published online: March 01, 2017
Accepted:
February 22,
2017
Received:
November 25,
2016
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
