Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Feb 15;17(2):e79056.
doi: 10.7759/cureus.79056. eCollection 2025 Feb.

Dumping Syndrome and Bile Acid Reflux Following Pyloroplasty and Gastric Peroral Endoscopic Myotomy (G-POEM) for Refractory Gastroparesis: A Systematic Review

Ryan Shargo  1 , Isaac Poonen-Honig  1 , Camille Thélin  2 , Christopher G DuCoin  3 , Rahul Mhaskar  1 , Salvatore Docimo  3 , Joseph A Sujka  3
Affiliations
Review

Dumping Syndrome and Bile Acid Reflux Following Pyloroplasty and Gastric Peroral Endoscopic Myotomy (G-POEM) for Refractory Gastroparesis: A Systematic Review

Ryan Shargo et al. Cureus. .

Abstract

Treatment options for medication- and diet-resistant gastroparesis include drainage procedures such as pyloroplasty and gastric peroral endoscopic myotomy (G-POEM). While dumping syndrome (DS) and bile acid gastritis (BAG) have been documented as complications following pyloric drainage procedures, limited evidence exists concerning their incidence after pyloroplasty and G-POEM for refractory gastroparesis. We performed a systematic review of outcomes following pyloroplasty and G-POEM for refractory gastroparesis (PROSPERO: CRD42024559654). PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for articles reporting rates of DS and BAG following pyloric drainage procedures. Assessed outcomes included rates of DS and BAG. Results were narratively synthesized and presented descriptively. Of the 2278 records reviewed, 10 studies were included. Six studies evaluated pyloroplasty, and four studies evaluated G-POEM. Nine studies reported incidence of DS, and two studies reported rates of BAG. The incidence of DS ranged from 0% to 23.1%, with a median incidence of 3.23% and an interquartile range of 6.95% among nine studies. The incidence of BAG ranged from 0% to 15.4% in two studies. The studies displayed high heterogeneity in study design, patient population, and co-interventions, precluding collective data analysis and limiting generalizability. All studies displayed a moderate to serious risk of bias. There exists a paucity of data regarding the incidence of DS and BAG following pyloroplasty and G-POEM for refractory gastroparesis. Despite the theoretical association of these complications with pylorus-modifying procedures, our findings suggest that they may be uncommon or underreported in the treatment of refractory gastroparesis. Improved reporting of these outcomes and robust prospective studies investigating the incidence of such complications are required.

Keywords: bile acid gastritis; bile acid reflux; dumping syndrome; gastric peroral endoscopic myotomy; gastroparesis treatment; gpoem; pyloroplasty.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Joseph A. Sujka declare(s) personal fees from Entera Medical. Dr. Sujka is a consultant for Entera Medical. Joseph A. Sujka declare(s) personal fees from Medtronic. Dr. Sujka is a consultant for Medtronic. Joseph A. Sujka declare(s) personal fees from Intuitive Surgical. Dr. Sujka is a consultant for Intuitive Surgical. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flow diagram for article identification, screening, and inclusion
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Adapted from Page et al. [24]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. Schol J, Wauters L, Dickman R, et al. United European Gastroenterol J. 2021;9:287–306. - PubMed
    1. Gastroparesis: new insights into an old disease. Usai-Satta P, Bellini M, Morelli O, Geri F, Lai M, Bassotti G. World J Gastroenterol. 2020;26:2333–2348. - PMC - PubMed
    1. How to interpret gastric emptying scintigraphy. Seok JW. https://pubmed.ncbi.nlm.nih.gov/21602998/ J Neurogastroenterol Motil. 2011;17:189–191. - PMC - PubMed
    1. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Kuo B, McCallum RW, Koch KL, et al. Aliment Pharmacol Ther. 2008;27:186–196. - PubMed
    1. Epidemiology, etiology, and treatment of gastroparesis: real-world evidence from a large US national claims database. Ye Y, Yin Y, Huh SY, Almansa C, Bennett D, Camilleri M. https://doi.org/10.1053/j.gastro.2021.09.064. Gastroenterology. 2022;162:109–121. - PubMed

LinkOut - more resources