Dumping syndrome after bariatric surgery

Obesity is a global problem. Bariatric surgery is the only way to lose enough weight to achieve health benefits. In addition to these desired effects, there are also undesirable side effects such as early and late dumping.
Early dumping occurs within an hour after a meal and consists of complaints such as nausea, diarrhea, sweating and palpitations. Late dumping occurs from one hour after the meal and complaints arise from low blood sugar and the body's response to this such as sweating, shaking, palpitations and drowsiness. This disease is also called postprandial hyperinsulinemic hypoglycaemia (PHH).
The studies described in this thesis investigated how often these side effects occur after bariatric surgery and what their genesis is.
A proportion of patients following a Roux-en-Y gastric bypass report complaints appropriate to early dumping (18%) or PHH (12%). These patients have a worse quality of life than the patients without dumping.
In a randomly selected group of patients who have undergone a gastric bypass, it appears that after a standard meal 26% of patients have symptoms of early dumping and 48% of patients have hypoglycaemia, but without associated complaints.
After the meal test, the blood analysis shows that the stimulation of intestinal hormones plays an important role in the development of early dumping. The intestinal hormones also play an important role in PHH, but the sensitivity to insulin in the body and the enhanced function of the Beta cells in the pancreas also are important factors.