Background: There has been no report concerning fasting Roux limb motilities and gut hormone in patients with early dumping syndrome (EDS) after total gastrectomy with Roux-en-Y reconstruction. The present study investigated interdigestive migrating motor complex, phase III (IMMC-pIII) in the Roux limb, changes in the plasma gut hormone levels, and the relationships among those parameters and EDS.
Methods: Forty-eight patients (35 men, 13 women; aged 33 to 69 years, mean, 59.8) 1.5 to 2.0 years (mean 1 year, 8 months) after total gastrectomy with Roux-en-Y reconstruction for early gastric cancer were allocated to two groups based on the presence or absence of EDS. The occurrence of IMMC-pIII was compared and changes in the plasma levels of both motilin (MT) and somatostatin (SOM) were monitored.
Results: None of the patients with EDS (n = 8) were recognized as having IMMC-pIII. In the IMMC-pIII positive group, MT and SOM increased sequentially from phase I through IMMC-pIII. In the IMMC-pIII negative group, MT and SOM were significantly lower than in the IMMC-pIII positive group during phases I, II, and IMMC-pIII (P <0.05, P <0.01, P <0.01, respectively).
Conclusions: There is an absence of IMMC-pIII in patients with EDS, and both MT and SOM might be necessary for IMMC-pIII generation.