Tirzepatide for refractory post-fundoplication dumping syndrome: A case report

Table 2 Comprehensive comparison of our case and published dumping syndrome cases treated with glucagon-like peptide-1 analogs

Ref.	Age/gender	Surgery type	Timing of symptom onset	Primary symptoms	Documented hypoglycemia	Failed prior therapies	Incretin therapy used	Initial dose	Maximum dose	Symptom response	Response to discontinuation	Follow-up duration
Our case	36/female	Toupet 270° fundoplication	6 months post-operation	Hunger pain, diarrhea, fatigue	No	Dietary modification	Tirzepatide	2.5 mg weekly	5 mg weekly	Complete resolution	Symptom recurrence	7 months before taper
Chiappetta and Stier[10]	52/female	Toupet fundoplication	12 months post-operation	Palpitations, nausea, sweating	Yes (nadir 35 mg/dL)	Dietary modification	Liraglutide	0.6 mg daily	1.2 mg daily	Significant improvement	Not attempted	Not specified
Ding et al[11]	53/male	Distal gastrectomy	16 months post-operation	Palpitations, sweating, dizziness	Yes (nadir 1.8 mmol/L)	Acarbose, diet	Beinaglutide	0.1 mg twice daily	0.1 mg twice daily	Complete resolution	Not attempted	1 month
Stortz and Lawler[12]	46/female	Sleeve gastrectomy	Approximately 8 months post-operation	Bloating, diarrhea, confusion	Yes (30-50 mg/dL)	Dietary modification	Tirzepatide	2.5 mg weekly	5 mg weekly	Complete resolution	Not reported	1.5 years