Evidence map›Paper›PMID 39406191›Full record

ArticleObesity facts2025

Postprandial Symptoms in a Mixed-Meal-Test after Bariatric Surgery: Clinical Experience and a Critical Review of Dumping Syndrome Definition and Management.

Azat Samigullin, Julia Weihrauch, Mirko Otto, Andrea Rech, Sandra Buchenberger, Michael Morcos, Per M Humpert

Abstract readEvaluation Study
In one paragraph

Article in Obesity facts, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Azat SamigullinClinic for Endocrinology and Metabolism, Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.
Julia WeihrauchClinic for Endocrinology and Metabolism, Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.
Mirko OttoSurgical Clinic, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Andrea RechSurgical Clinic, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Sandra BuchenbergerClinic for Endocrinology and Metabolism, Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.
Michael MorcosClinic for Endocrinology and Metabolism, Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.
Per M HumpertClinic for Endocrinology and Metabolism, Stoffwechselzentrum Rhein-Pfalz, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite recent attempts to reach a consensus on the diagnostic criteria and treatment of dumping syndrome (DS) after bariatric surgery, many questions about the clinical applicability and significance of standardized provocation tests remain unanswered. The objective of this study was to retrospectively evaluate a mixed-meal-test (MMT) based on general nutritional recommendations after bariatric surgery and its clinical value in diagnosing DS.

methodsThe MMT contained 15.5 g of protein, 10 g of fat, 20.7 g of carbohydrates, and 3.1 g of dietary fiber, totaling 241 kcal. Symptoms based on the Sigstad Score, along with blood sugar, hematocrit, pulse rate, and blood pressure, were collected as primary readouts. The analysis included 58 MMTs from 56 patients who reported postprandial symptoms indicative of DS and were referred to the clinic by surgeons or general practitioners.

resultsAlthough all individuals reported significant symptoms at home, the MMT showed a positive symptom score (Sigstad Score ≥7) in only 16 cases (28%). Neither a heart rate increase >10 BPM nor the 3% hematocrit increase suggested as cut-offs for early DS by the consensus paper were associated with the Sigstad Score or individually reported symptoms. None of the participants had a postprandial glucose decrease below 50 mg/dL; one fell below 60 mg/dL and 14 fell below 70 mg/dL. A blood glucose decrease below 70 mg/dL was not associated with symptoms.

conclusionThe MMT showed that only a minority of patients reported classical DS symptoms under controlled conditions. Changes in hematocrit, heart rate, and blood sugar decrease below 70 mg/dL did not help to predict symptoms in the individuals studied. The data, in the context of existing evidence, suggest that provocation tests have little value in clinical practice and that DS as a clinical entity after bariatric surgery should be reevaluated.

Indexed as

Bariatric SurgeryDumping SyndromeMealsPostprandial PeriodAdultBlood GlucoseFemaleHematocritHumansMaleMiddle AgedObesity, MorbidRetrospective StudiesBlood GlucoseBariatric surgeryDumping syndromeMixed meal testOral glucose tolerance testPostprandial hypoglycemia

Identifiers

PMID39406191
PMCPMC12017760

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.