يوجد بروتوكول منظم للمرضى الذين يعانون من متلازمة الإغراق والذين لا تزال أعراضهم غير مضبوطة بشكل كافٍ بعد العلاج بنظائر السوماتوستاتين — يحدد هذا البروتوكول كلاً من الشروط التي تستوجب التصعيد والتدخلات التي ينبغي النظر فيها في الخطوة التالية.
DOI: 10.2147/CEG.S392265
After conservative steps have failed to manage symptoms of dumping syndrome, continuous enteral feeding or surgical interventions can be considered.
Continuous enteral feeding by a jejunostomy or tube in the remnant stomach avoids symptoms triggered by meals but is invasive, associated with complications and has therefore a limited place in the management of dumping syndrome.
In the literature, this procedure is referred to as transoral outlet reduction (TORe), or endoscopic gastrojejunostomy revision (EGJR), or revision of the gastrojejunal anastomosis (GJA).
Successful use of GLP-1RAs has also been described in individual cases: a patient with postsurgical late dumping syndrome symptoms after Toupet fundoplication (liraglutide) and a patient after distal gastrectomy (beinaglutide) by reducing symptomatic postprandial hyperinsulinemic hypoglycemic events.
Indeed, in a small-scale study with 21 patients, the SGLT-1 inhibitor canagliflozin reduced over 85% of the hypoglycemic episodes in patients with severe postprandial hypoglycemia.
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