Did Someone Say Pyloric Valve?
I hope those whom still have a properly functioning pylorus and dump will find out why this is occurring in them as well. I again will clarify that my info speaks of dumping and it's relation to pyloric removal, not other causes.
Have a great day! ~GG
http://clinicaltrials.gov/ct2/show/NCT00998374
Comparison Between Pyloric Preserving and Non-Pyloric Preserving Bariatric Surgery With Glucose Challenge This study is currently recruiting participants. Study NCT00998374 Information provided by Covidien First Received: October 15, 2009 Last Updated: November 17, 2010 History of Changes
| Tracking Information | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| First Received Date ICMJE | October 15, 2009 | ||||||||
| Last Updated Date | November 17, 2010 | ||||||||
| Start Date ICMJE | September 2009 | ||||||||
| Estimated Primary Completion Date | January 2012 (final data collection date for primary outcome measure) | ||||||||
| Current Primary Outcome Measures ICMJE |
Reactive hypoglycemia status and ratio between the maximum serum glucose level and the minimum serum glucose level during glucose tolerance testing. [ Time Frame: 6, 9, and 12 months post-operatively ] [ Designated as safety issue: Yes ] | ||||||||
| Original Primary Outcome Measures ICMJE | Same as current | ||||||||
| Change History | Complete list of historical versions of study NCT00998374 on ClinicalTrials.gov Archive Site | ||||||||
| Current Secondary Outcome Measures ICMJE |
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| Original Secondary Outcome Measures ICMJE | Same as current | ||||||||
| Descriptive Information | |||||||||
| Brief Title ICMJE | Comparison Between Pyloric Preserving and Non-Pyloric Preserving Bariatric Surgery With Glucose Challenge | ||||||||
| Official Title ICMJE | Comparison Between Pyloric Preserving and Non-Pyloric Preserving Bariatric Surgery With Glucose Challenge | ||||||||
| Brief Summary |
This study will compare glucose and simple carbohydrate sensitivity. The hypothesis is that rapid emptying of high-glycemic index foods after Roux-En-Y gastric bypass (RYGB) causes reactive hypoglycemia. It is believed that the controlled release offered by an intact pylorus will be advantageous for long term results in bariatric surgery. This study can provide a scientific rationale, in a short duration of time, for why pylorus sparing surgery, such as the sleeve gastrectomy or duodenal switch, may offer therapeutic advantages, as compared to non-pyloric sparing surgery, namely the gastric bypass. |
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| Detailed Description |
Clinical Trial Objective: The objective of this clinical trial is to determine whether an intact pylorus prevents reactive hypoglycemia following challenge with liquid glucose preparation and/or solid load made of refined flour product that is a simple carbohydrate. Clinical Trial Design: This is a prospective, non-randomized, clinical trial. |
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| Study Phase | |||||||||
| Study Type ICMJE | Observational | ||||||||
| Study Design ICMJE | Observational Model: Case-Only Time Perspective: Prospective |
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| Condition ICMJE |
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| Intervention ICMJE | |||||||||
| Study Arms / Comparison Groups | Pyloric-sparing group vs. non-pyloric sparing group
Pylorus sparing = sleeve gastrectomy and duodenal switch procedures Non-pylorus sparing = gastric bypass procedure |
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| Publications * | |||||||||
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline. |
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| Recruitment Information | |||||||||
| Recruitment Status ICMJE | Recruiting | ||||||||
| Estimated Enrollment ICMJE | 60 | ||||||||
| Completion Date | |||||||||
| Estimated Primary Completion Date | January 2012 (final data collection date for primary outcome measure) | ||||||||
| Eligibility Criteria ICMJE |
Inclusion Criteria:
Exclusion Criteria:
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| Gender | Both | ||||||||
| Ages | 19 Years and older | ||||||||
| Accepts Healthy Volunteers | Yes | ||||||||
| Contacts ICMJE |
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| Location Countries ICMJE | United States | ||||||||
| Administrative Information | |||||||||
| NCT ID ICMJE | NCT00998374 | ||||||||
| Other Study ID Numbers ICMJE | AS08018 | ||||||||
| Responsible Party | Mitchell Roslin, MD, Lenox Hill Hospital | ||||||||
| Study Sponsor ICMJE | Covidien | ||||||||
| Collaborators ICMJE | |||||||||
| Investigators ICMJE |
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| Information Provided By | Covidien | ||||||||
| Verification Date | November 2010 | ||||||||
Ht. 5'2 HW 234/GW 150/LW 128/CW 132 Size 18/20 to a size 4 in 9 months!
~GG
www.reactivehypoglycemic.net says this about RH:
Reactive Hypoglycemic can still produce insulin through their pancreas, the hormone that is needed to regulate blood glucose. It’s just not as efficient as it should be, resulting in too much production of insulin in the blood stream, causing the blood sugar to drop to a very low level. It’s the body’s inability to handle large amounts of sugar that most people consume in our day. Our society’s diet is overloaded with sugar, alcohol and caffeine, as well as tobacco and stress, giving rise to this medical condition.
If there is a rise in this medical condition in the general population, then the pyloric is not the biggest problem or suspect in RH. It may be one of the factors but is not THE factor. I'll see what I can do about finding some research papers on RH.
Ht. 5'2 HW 234/GW 150/LW 128/CW 132 Size 18/20 to a size 4 in 9 months!
Pyloric function also has other added benefits outside of dumping (or lack there of)
~drinking before, during and after meals
~chewing normally
~normal bite sizes
~better tolerance of dense proteins
here's another link I had found from a previous post:
app.barisecure.com/resources/NIWLS_NMD.doc
Dumping Syndrome
The two types of Dumping Syndrome are alternately discussed as a benefit or side effect of RNY. Early Dumping typically occurs 30 to 60 minutes after eating high concentrations of sugars or overeating. Because the pylorus is eliminated with RNY, the pouch can empty rapidly into the jejunum (the duodenum is bypassed). For reasons possibly connected to changes in blood flow and/or post-prandial release of gut peptides[i], patients experience a sudden and very unpleasant onset of symptoms including cramps, nausea and vomiting, explosive diarrhea, and dizziness, tachycardia, decreased blood pressure, and flushing. Early dumping is common in the first year after RNY and is promoted as behavior modification, since it is a very unpleasant response to eating sweets.
Late Dumping occurs one to three hours after eating, also in response to sugars or refined carbohydrates. Symptoms of severe hypoglycemia (sweating, tremors, exhaustion, decreased consciousness, fainting, hunger and sugar cravings) result from the efficiency of the small bowel in absorption of simple carbohydrate. This, in turn, leads to a hyperinsulinemic response[ii].
Dumping syndrome is reported in as many as 50[iii] to 70 percent of RNY patients.[iv] Dietary recommendations include reduction of sugar and refined carbohydrate, avoidance of fluids at meal times (to slow gastric emptying), and consumption of protein-rich meals[v]. The somatostatin analog, octreotide, can be used to control symptoms[vi] in extreme or refractory cases.
5 Carvajal SH, Mulvihill SJ. Postgastrectomy syndromes: dumping and diarrhea. Gastroenterol ClinNorth Am. 1994;23(2):261–279.
6Holdsworth CD, Turner D, McIntyre N: Pathophysiology of post-gastrectomy hypoglycaemia. Br Med J 1969 Nov 1; 4(678): 257-9
7Sugerman HJ, Starkey JV, Birkenhauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters.Ann Surg. 1987;205(6):613–624.
8Pories WJ, Caro JF, Flickinger EG, Meelheim HD, Swanson MS. The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Ann Surg. 1987;206(3):316–323.
9 Elliot K. Nutritional considerations after bariatric surgery. Crit Care Nurs Quart. 2003;26(2):133-138.
10 Gray JL, Debas HT, Mulvihill SJ: Control of dumping symptoms by somatostatin analogue in patients after gastric surgery. Arch Surg 1991 Oct; 126(10): 1231-5; discussion 1235-6.
