Transoral outlet reduction (TORe) for severe dumping syndrome

Posted by brendanordstrom @brendanordstrom, Feb 17 9:54pm

Has anyone tried transoral outlet reduction (TORe) for severe dumping syndrome after a roux en Y gastric bypass?

I have both early and late dumping syndrome that continues to get progressively worse. I have severe reactive hypoglycemia and I can only eat a very limited type and amount of foods. I now must eat primarily protein as carbs will shoot my glucose levels up sky-high and then I drop dangerously low. I now wear a continuous glucose monitor as I no longer feel the hypoglycemia until I'm disorientated.
In addition, I now also have pancreatic exocrine dysfunction and have to take pancreatic enzymes while minimizing my fats.

I have tried acarbose with minimal effect and unfortunately, I developed elevated liver enzymes as a side effect. If I get clearance from my cardiologist, I will trial octreotide to manage the dumping syndrome with plan B being surgical management.

I have read about transoral outlet reduction for the treatment of dumping syndrome but I was wondering if anyone else has tried it. Did it work and was it worth it?
Living with severe dumping syndrome has made my life miserable and I really want to be able to manage it.

TIA
Brenda

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Colleen Young, Connect Director | @colleenyoung | Feb 20 8:21pm

Hi @brendanordstrom, living with severe dumping syndrome really limits your quality of life. Here's a blog post about TORe.

- Gastric Bypass Transoral Outlet Reduction: Endoscopic (TORe procedure) https://connect.mayoclinic.org/blog/weight-management-1/newsfeed-post/gastric-bypass-transoral-outlet-reduction-endoscopic-tore-procedure/

I believe fellow members like @turberg @cntrlcoastgirl @roch and others have experienced dumping, although I believe only occassionally in response to certain foods.

I hope octreotide is possible for you and that it works. Did your team suggest TORe as a possible solution?

brendanordstrom | @brendanordstrom | Feb 26 12:13pm

Thank you, Colleen!
I really appreciate your response. I have been cleared by cardiology for the use of octreotide. I see my endocrinologist in March and will hopefully start the medication then. My biggest issue is that I have so many specialists. Now that I have met with the admission PA of the U of M bariatric team, I'm hoping to pull everything over to the same page. I have only met with the admission PA so far but when I asked if they do TORe I was told they have a physician who does do the procedure.

I have done most of the research related to my problem myself. I happen to be a nurse so I know what to look for and where to look. But I would love to have a team that would discuss the entire problem and provide options.