Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Late dumping syndrome or postprandial reactive hypoglycaemic syndrome after bariatric surgery

Nature Reviews Endocrinology volume 17, page 317 (2021)Cite this article

Subjects

In the August 2020 issue of Nature Reviews Endocrinology, a group of researchers proposed an international consensus on the diagnosis and management of dumping syndrome (Scarpellini, E. et al. Nat. Rev. Endocrinol. 16, 448–466 (2020)1). On the basis of the limited evidence available, the authors made efforts to fill a gap in clinical guidance on how to deal with these complications that sometimes severely impact the life of patients. However, we feel that some of the recommendations are problematic.

Firstly, they propose the use of ‘late dumping syndrome’ to describe the occurrence of hypoglycaemic symptoms in these patients. This terminology, however, is misleading as these symptoms and underlying pathophysiology, albeit incompletely understood, are not related to mechanical or physical processes whereby ingested nutrients are ‘dumped’. Instead, symptoms are probably related to changes in postprandial absorption of carbohydrates and associated hormonal responses in incretin and insulin release. Therefore, we suggest using the term ‘postprandial reactive (hypoglycaemic) syndrome’ instead.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Scarpellini, E. et al. International consensus on the diagnosis and management of dumping syndrome. Nat. Rev. Endocrinol. 16, 448–466 (2020).

    Article  Google Scholar 

  2. Arts, J. et al. Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping. Clin. Gastroenterol. Hepatol. 7, 432–437 (2009).

    Article  CAS  Google Scholar 

  3. Roslin, M. et al. Abnormal glucose tolerance testing following gastric bypass demonstrates reactive hypoglycemia. Surg. Endosc. 25, 1926–1932 (2011).

    Article  Google Scholar 

  4. Van der Kleij, F. G. H., Vecht, J., Lamers, C. B. H. W. & Masclee, A. A. M. Diagnostic value of dumping provocation in pations after gastric surgery. Scand J. Gastroenterol. 31, 1162–1166 (1996).

    Article  Google Scholar 

  5. Lev-Ran, A. & Anderson, R. W. The diagnosis of postprandial hypoglycemia. Diabetes 30, 996–999 (1981).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Ghent University Hospital, Ghent, Belgium

    Frederique Van de Velde & Bruno Lapauw

Authors
  1. Frederique Van de Velde
    View author publications

    Search author on:PubMed Google Scholar

  2. Bruno Lapauw
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Frederique Van de Velde.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van de Velde, F., Lapauw, B. Late dumping syndrome or postprandial reactive hypoglycaemic syndrome after bariatric surgery. Nat Rev Endocrinol 17, 317 (2021). https://doi.org/10.1038/s41574-021-00473-6

Download citation

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41574-021-00473-6

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing