Now this is a very interesting brand new study released about the Sleeve and dumping syndrome.. Please this is not bashing the Sleeved in any way; I am just reporting the side effects that many people did not realized happened -- until after they were Sleeved.

I know some people may welcome this but many are not so happily surprised. I guess this is good info for people researching...some people may want to dump and some people may not.

Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy.

Tzovaras G, Papamargaritis D, Sioka E, Zachari E, Baloyiannis I, Zacharoulis D, Koukoulis G.

Source

Department of Surgery, University Hospital of Larissa, Viopolis, Larissa 411 10, Greece. [email protected]

Abstract

BACKGROUND:

Dumping syndrome is a well-known complication after upper gastrointestinal (GI) surgery. There are scarce data in the literature about the incidence of dumping after bariatric operations but, certainly no relation between this syndrome and laparoscopic sleeve gastrectomy (LSG) has been attempted.

METHODS:

We conducted a prospective clinical study in order to evaluate the potential presence, incidence and severity of Dumping syndrome after LSG. Thirty one non-diabetic morbidly obese patients (eight male, 23 female) eligible for LSG were evaluated. Median age was 38 (22-58 years) and mean body mass index (BMI) was 45.55 (± 5.37). The diagnosis of dumping syndrome was based on clinical provocation of signs and symptoms using an oral glucose challenge before and 6 weeks after the operation. The Sigstad's dumping score was estimated in order to separate dumpers from non-dumpers, and the Arts questionnaire was completed to distinguish between early and late dumping. Moreover, blood glucose levels during the oral glucose challenge were measured.

RESULTS:

No patient had symptoms of dumping after provocation preoperatively, whereas after LSG 9 patients (29%) experienced definite dumping and other 5 patients (16%) symptoms suggestive of dumping syndrome. Arts' questionnaire demonstrated that dumping occurrence after LSG was associated with early symptoms. Late hypoglycaemia occurred in one patient.

CONCLUSION:

A significant proportion of patients after LSG experienced dumping syndrome upon provocation. It seems that LSG should no longer be considered as a pure restrictive procedure, and it might be an option for heavy sweeters by changing their food tolerance patterns.

I am sleeved and occasionally get dumping syndrome if I eat too much sugar and/or fried foods.  Its not that frequent and I have not regretted my sleeve at all.  From what I understand there are some of us prone to this but certainly not the majority of sleevers.

Kelli

You are reporting anything new.

There are older studies on gastric transit time for gastrectomy patients.

Even people without altered guts get dumping. Reactive hypoglycemia, and other transit time issues have been studied, published and noted for years on end.

If anyone does the full research on the procedure, this is not "new", it's just the newest study available for everyone.

In 3 years post band to VSG revision, I have never dumped on anything and I do not restrict any food type/group.

The study is also not complete as many are not and there is a lot of information missing. The study on monitors 31 patients plus these patients still had obese BMI ranges. Throwing high glucose into newly post-op patients could cause an entire slew of issues. Especially if there was no sugar, low carb pre-op and post-op diet requirement/guideline in place. I would venture to guess that just about anyone who was forced into no sugar intake then to have loads of glucose thrown into their body would have "suggestive" dumping symptoms.

Sure dumping is not NEW with the Sleeve, I've had friends that got a revision to the Sleeve before you got yours and they dumped and STILL dump and it can get debilitating ...something they had no clue occurred with the Sleeve since it "USED" to be advertised as a "Purely Restrictive Surgery" very important information for those who are researching and many people avoid RNY because of dumping, some people do not want that kind reaction to eating any type of foods, especially when you get older, many people would like to enjoy occasional sweets or treats without horrible dumping reactions, but again as you say some people are ok with it.

Many people with RNY don't dump either, but many do and it can get debilitating over the years,

Dumping is now one of official "side effects" of the Sleeve, just like dumping is an official "side effect" of RNY......if it was just a coincidence and if it was not a "horrible" experience for many who eat not only sweets but carbs, it would not be well documented with the National Institute of Health.

That's really interesting, because you always hear that dumping results from the stomach contents empyting into a different that normal place in the small intestine, so I wonder why just having a reduce volume of stomach tissue would cause it?

Dev, that is what I can't understand and many would get mixed messages with the Sleeve dumping because they mentioned the Pylorus is reserved, but despite that, MANY people suffer from dumping syndrome with the Sleeve, also many people suffer from the same type of vitamin deficiencies with the Sleeve as in RNY, which is bizzare.

But when you really think about it they remove most of the Stomach that needs vital nutrients such as B12 and I remember a few folks that got the Sleeve back in 2007 complained about some type of rare issues of absorbing nutrients and many have to take vits just like RNY folks do.

Remember the Sleeve is still a NEW surgery, I am not talking about the old gastrecotomies, the method of how it is performed now is new and surgeons really don't know the long term effects of it and now they are finally getting data.

Patient's level of compliance with vitamin and appropriate nutrient dense meal intake is essential. I know bandsters with deficiencies. So, ALL surgeries have vitamin issues. AND, stomachs do not need b12. The portion of the stomach that produces the intrinsic factor is removed and "some" VSG patients need to supplement with a sublingual or injectable option for B12 absorption to be maintained at normal levels. B12 is a water soluble vitamins therefore we (none of us or normies) store it. B12 deficiencies happen to people without altered guts too.


The sleeve is not "new". It has been performed over 10 years as a stand-alone. At least if you're  going to spew information and contribute to the research aspect of surgery, get the facts straight.

The Standalone Sleeve is an evolutionary weight loss surgery, I understand that it evolved from the DS, and was first performed on a few patinets from 2001-2003 by Dr Gagner on very high risk high BMI patients. 

Source:
http://bariatrictimes.com/2010/02/18/the-history-of-sleeve-g astrectomy/

But the Sleeve (standalone) is STILL NEW compared to the lap band (almost 30 years) Lap band History source: http://www.lapband.com/en/learn_about_lapband/device_how_it_ works/history/

Gastric Bypass has been around the longest since the 1950's and has the longest clinic record.

http://www.twoop.com/medicine/archives/2005/10/gastric_bypas s_surgery.html

And, all the surgeries have "evolved" in some manner. BPD and DS, RNY from the old standard stomach stapling, the "new" lapband from the old  band, the non-adjustable band, etc etc, hip replacements have come along way in the last 20 years. 

So, what is your point again? I'm still failing to see a valid point on the "lack of research" on gastrectomies. Regardless of shape of the remaining stomach/technique, which if you had done any level of true research, there is NO standard sleeve shape or guideline. There are suggestions to lesser complication, to prevent strictures and so on. Just as there are varying techniques for placing bands, making the stoma on a RNY patient different sizes, and varying opinions/suggestions on the length of the common channel for RNY and DS patients.

All surgeries are tweeked and "improved" as the years pass and research progresses.

Because of the "shape" of the sleeve, lack of fundus, typically there is 'more pressure' in our stomachs thus it "mushes" the food harder, opening the pyloric valve to allow food into the intestines faster than say a Pouch/Stoma combination. When specific foods are consumed, let's just for ****s and giggles say Ice Cream, there's not any mushing need, it's essentially a liquid, POPs open the pyloric valve and straight into the small intestine where sugar/carbs are absorption. The process of actually enzymes breaking down the "sugar" into different glucose factors begin in the mouth with salivia, and then as it goes through different type of "sugar" molecules are delivered to various organs.

Like I posted above, transit time, rapid gastric emptying times post gastrectomies has been studied, documented and researched for years on end. It's not "new" information in the least. If a surgeon does NOT advise his patients of this, that's the surgeon lack of eduating his patients, and if the patient goes in blindly without researching the full ramifications of a gut-altering procedure then that is their own lack of educating themselves.

It's more "semantics" and not always what is consumed. It's a matter of individual transit time to some extent. And, it doesn't matter "where" the food dumps into the intestines, absorption is absorption when there is zero bypassed intestine.

This is just one of the studies being shared over on the VSG forum. Again, this "not a restrictive procedure only" isn't "NEW" science or information.

http://www.springerlink.com/content/q7uv5737u0612646/

http://www.bariatricspro.com/imageServer.aspx/doc213333.pdf?contentID=20351&contenttype=application/pdf

http://www.cme.umn.edu/prod/groups/med/@pub/@med/@cme/documents/content/med_content_201147.pdf