Lawati Abdullah Al, Alhabsi Ayman N, Sabti Ali Al, Krishnan Raksha S, Alkindi Sulaiman, Das Srijit, Al-Abri Mohammed
Department of Surgery, Sultan Qaboos University Hospital, Al-Khoud 123, Muscat, Oman.
Department of Medicine, Royal College of Surgeons, Dublin 2, Dublin, Republic of Ireland.
Metabol Open. 2025 Aug 25;27:100387. doi: 10.1016/j.metop.2025.100387. eCollection 2025 Sep.
Dumping syndrome (DS) is a known complication following bariatric surgery, caused by rapid gastric emptying into the small intestine. It presents in two forms: early dumping, with gastrointestinal and vasomotor symptoms occurring within 30-60 min after meals; and late dumping, which arises 1-3 h postprandially due to reactive hypoglycaemia. Standard management includes dietary changes and medications, but tolerability and long-term efficacy are variable. Recently, interest has grown in using natural products and nutritional compounds as adjuncts or alternatives. Fibre-rich foods, sugar substitutes, and medicinal plants may delay gastric emptying, reduce glucose spikes, or modulate gut hormones such as GLP-1 and GIP. Several phytochemicals, polyphenols, flavonoids, alkaloids, and terpenoids have demonstrated promise in reducing DS symptoms, especially in late dumping. Functional foods may enhance satiety, slow carbohydrate absorption, and improve glycaemic control. Although most data are from preclinical or limited clinical studies, natural compounds appear to be well-tolerated and safe, offering potential advantages over standard pharmacological agents. This review summarises emerging evidence on the role of natural products in managing DS, their mechanisms of action, and their clinical relevance in post-bariatric care. The findings aim to support translational metabolic care and provide practical guidance for clinicians and dietitians managing DS in diverse patient populations.
倾倒综合征（DS）是减肥手术后一种已知的并发症，由胃内容物快速排空至小肠所致。它有两种表现形式：早期倾倒，在进食后30 - 60分钟内出现胃肠道和血管运动症状；晚期倾倒，由于反应性低血糖在餐后1 - 3小时出现。标准治疗包括饮食调整和药物治疗，但耐受性和长期疗效各不相同。最近，使用天然产物和营养化合物作为辅助或替代治疗的兴趣日益增加。富含纤维的食物、代糖和药用植物可能会延迟胃排空、减少血糖峰值或调节肠道激素，如胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）。几种植物化学物质、多酚、黄酮类化合物、生物碱和萜类化合物已显示出减轻DS症状的前景，尤其是在晚期倾倒方面。功能性食品可能会增强饱腹感、减缓碳水化合物吸收并改善血糖控制。尽管大多数数据来自临床前或有限的临床研究，但天然化合物似乎耐受性良好且安全，与标准药物相比具有潜在优势。本综述总结了关于天然产物在管理DS中的作用、其作用机制以及在减肥后护理中的临床相关性的新证据。这些发现旨在支持转化代谢护理，并为管理不同患者群体中DS的临床医生和营养师提供实用指导。
