Prevalence of early dumping syndrome 3-6 years after Roux-en-Y Gastric Bypass.

Wijma, R.B. (Ragnhild) (2015) Prevalence of early dumping syndrome 3-6 years after Roux-en-Y Gastric Bypass. thesis, Medicine.

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Abstract

Background Although early dumping syndrome is a well-known complication after Roux-en-Y Gastric Bypass (RYGB), data on the long-term prevalence are limited and inconclusive. This study describes the prevalence of early dumping syndrome in patients 3 to 6 years after primary RYGB, using 3 different measurements to define a diagnosis and exploring the concordance between those definitions. Methods In this cross-sectional study, a total of 140 patients after RYGB were randomly selected and approached. Of these, 49 patients underwent a Mixed-Meal Tolerance Test using a liquid nutrition supplement (Ensure Plus 200ml). Heart Rate (HR) and Haematocrit (Ht) were measured at baseline and 10, 20, 30 and 60 minutes after the test meal. Symptoms were recorded by the Dumping Severity Score (DSS) at baseline, 30 and 60 minutes after the test meal. The following definitions of early dumping were used: HR-increase of >10 beats per minute (HR-criterion), a Ht-increase of >3% (Ht-criterion 3%) and a Ht-increase of >10% (Ht-criterion 10%) and three categories of the DSS-score: DSS-criterion 1) no complaints (score 0, DSS-criterion 2) some complaints (patients with some complaints that did not meet the definition of category 3), DSS-criterion 3) severe complaints (score ≥2 gastrointestinal symptoms and ≥1 vegetative symptom). The concordance between the symptoms and the objective measures was also estimated. Results Prevalence of early dumping was 84% (n=41) according to HR-criterion 31% (n=15) according to Ht-criterion >3%; 4% (n=2) according to Ht >10%; 25% (n=12) according to DSS criterion 2; and 10% (n=5) according to DSS criterion 3 The agreement between the objective measures and the symptoms was poor and there were no differences in the change of the objective measures after the test meal between the patients having and not having symptoms. Conclusions The results show a large discrepancy of the prevalence of early dumping between the different diagnostic criteria used in literature, with poor concordance between the objective and symptomatic measures. Seen that no differences were found in the change of the objective measures between the dumping and non-dumping groups as defined by the dumping severity score, this study suggest that early dumping should be considered a symptom-diagnosis. This also holds the most clinical relevance.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Emous, Drs. Marloes and Bariatric en metabolic surgeon, Medical Centre Leeuwarden
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:54
Last Modified:	25 Jun 2020 10:54
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1463

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