vasoactive-intestinal-peptide and Dumping-Syndrome

To avoid dumping after Billroth gastrectomy, we designed pylorus and antroseromuscular-flap preserving subtotal gastrectomy (PAFPG). The mean maximal plasma level of VIP (vasoactive intestinal peptide) in PAFPG after oral hypertonic glucose was close to that in the control. Compared with PAFPG group, the plasma VIP concentrations after hypertonic glucose ingestion in BI and BII group were significantly higher, and the concentration of plasma VIP in dumpers was significantly higher than that in non-dumpers after BI or BII gastrectomy. The results suggest that the amount of VIP release is related to the type of reconstruction after gastrectomy.

Topics: Dumping Syndrome; Duodenogastric Reflux; Gastrectomy; Glucose Solution, Hypertonic; Humans; Peptic Ulcer; Surgical Flaps; Vasoactive Intestinal Peptide

Plasma vasoactive intestinal peptide (VIP), blood glucose concentration and hematocrit (HCT) were measured in 15 patients after Billroth-II subtotal gastrectomy (B-II SG) and 8 healthy controls before and after oral glucose ingestion. In B-II SG group the rate of rise of VIP concentration was in positive correlation to the rate of rise of HCT (r = 0.501 P < 0.05) and to that of blood glucose (r = 0.715 P < 0.01). Also, the elevation rate of HCT blood glucose and VIP concentration was significant higher in B-II SG group than in controls (P < 0.05). It was found that the elevation rate of VIP concentration was much higher in patients with dumping syndrome after B-II SG than those without (P < 0.05). The results suggest that VIP may play a role in the pathogenesis of dumping syndrome.

Topics: Blood Glucose; Dumping Syndrome; Gastrectomy; Glucose; Hematocrit; Humans; Middle Aged; Peptic Ulcer; Vasoactive Intestinal Peptide

Topics: Blood Glucose; Dumping Syndrome; Female; Humans; Male; Middle Aged; Somatostatin; Vasoactive Intestinal Peptide

Topics: Animals; Cardiac Output; Dogs; Dumping Syndrome; Duodenum; Female; Heart Rate; Male; Portal Vein; Vascular Resistance; Vasoactive Intestinal Peptide

Infusion of somatostatin reduced the symptoms of the early dumping syndrome after oral glucose was given and also reduced the associated tachycardia and rise in packed cell volume. It inhibited the secretion of enteroglucagon, neurotensin, and vasoactive intestinal polypeptide, which are raised in patients with the dumping syndrome and may have an aetiological role. It also prevented the reactive hypoglycaemia of late dumping by inhibiting the release of gastric inhibitory polypeptide and insulin. Somatostatin, possibly through its inhibitory effects on hormonal secretion, may have a role in the management of patients with the early and late dumping syndrome.

Topics: Blood Glucose; Dumping Syndrome; Glucagon-Like Peptides; Hematocrit; Humans; Male; Middle Aged; Neurotensin; Somatostatin; Time Factors; Vasoactive Intestinal Peptide

This study evaluated the effect of gastric bypass on the glucose, insulin, vasoactive intestinal peptide (VIP), neurotensin, and motilin response to orally administered glucose in eight morbidly obese patients before and after operation. Preoperatively, all eight patients remained asymptomatic during an oral glucose tolerance test, which showed glucose intolerance and hyperinsulinism. Plasma VIP, neurotensin, and motilin remained below detectable levels for the entire test. At three months following gastric bypass (21% weight loss), all eight patients became acutely ill during a repeated oral glucose tolerance test and had the following symptoms: facial flushing (eight patients), palpitations (eight patients), nausea (seven patients), abdominal fullness (seven patients), pallor (four patients), diaphoresis (two patients), vomiting (two patients), and diarrhea (two patients). Significant release of neurotensin occurred in seven patients while three patients had release of VIP, further implicating these two peptides as part of the pathophysiologic spectrum of the "dumping syndrome."

Topics: Adult; Blood Glucose; Dumping Syndrome; Female; Glucose Tolerance Test; Humans; Jejunum; Male; Neurotensin; Obesity; Postoperative Complications; Stomach; Vasoactive Intestinal Peptide

To determine the effect of gastric surgery on the plasma vasoactive intestinal peptide (VIP) concentration, 13 patients with gastrectomy and seven controls were given an oral hypertonic load (200 ml 50% glucose solution). Blood was taken at intervals during the test for measurement of VIP and blood glucose concentrations and packed cell volume. At the same time observations were made on the occurrence of dumping symptoms and a record kept of the pulse rate. VIP values in the patients with gastrectomy were significantly increased by glucose ingestion, while these did not alter in controls (p less than 0.001). There was a highly significant correlation between the rate of rise in plasma VIP concentration and the rates of rise in packed cell volume (r = 0.85; p less than 0.001) and blood glucose concentration (r = 0.76; p less than 0.01) in patients with gastrectomy. Changes in packed cell volume and blood glucose values and the occurrence of dumping symptoms during the test were significantly different when postoperative patients were compared with controls (p less than 0.001, p less than 0.005, and p less than 0.001 respectively). Furthermore, when the patients with gastrectomy were divided into those without symptoms and those with dumping after meals the latter group showed a significantly greater rise of VIP (p less than 0.05). Despite the increased plasma VIP concentrations observed during dumping, VIP cannot be taken as the sole factor in the pathogenesis of the dumping syndrome.

Topics: Aged; Blood Glucose; Chromatography, Gel; Dumping Syndrome; Gastrectomy; Gastrointestinal Hormones; Hematocrit; Humans; Middle Aged; Vasoactive Intestinal Peptide