Diagnosis and Treatment of Dumping Syndrome After Gastric Bypass for Morbid Obesity

Dumping syndrome as a clinical entity was recognized initially after gastric resections in the early twentieth century. It once again came to the forefront with the introduction of bariatric procedures. It was considered integral for weight loss after such procedures although increasingly it has been questioned. Despite improved understanding, its pathophysiology remains elusive. Clinical suspicion remains the cornerstone of the diagnosis as the scoring systems, emptying studies, and glucose tolerance tests are not validated for bariatric surgery. Dietary measures especially avoiding simple sugars, frequent meals, and separating liquids from solids improve symptoms. Medications also improve symptoms, especially long-acting formulations. Surgical treatment is reserved for intractable symptoms, and gastric bypass reversal, conversion of gastric bypass to sleeve, and pouch restriction seem to achieve better success rates with less morbidity.