Adeniran O, Almusabeh H, Adekolu A, Diab K, Hadam J, Bham NS, Sobani ZA. Tirzepatide for refractory post-fundoplication dumping syndrome: A case report. World J Gastroenterol 2026; 32(45): 122564 [DOI: 10.3748/wjg.122564]
Corresponding Author of This Article
Zain A Sobani, Assistant Professor, Department of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506, United States. zsobani@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
case-report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 7, 2026; 32(45): 122564 Published online Dec 7, 2026. doi: 10.3748/wjg.122564
Tirzepatide for refractory post-fundoplication dumping syndrome: A case report
Olanrewaju Adeniran, Hamza Almusabeh, Ayowumi Adekolu, Kareem Diab, Jennifer Hadam, Nida S Bham, Zain A Sobani
Olanrewaju Adeniran, Ayowumi Adekolu, Kareem Diab, Jennifer Hadam, Zain A Sobani, Department of Gastroenterology and Hepatology, West Virginia University, Morgantown, WV 26506, United States
Hamza Almusabeh, Department of Medicine, West Virginia University, Morgantown, WV 26506, United States
Nida S Bham, Department of Thoracic Surgery, Heart and Vascular Institute, West Virginia University, Morgantown, WV 26506, United States
Author contributions: Adeniran O and Almusabeh H contributed to writing and editing the manuscript; Adekolu A and Diab K contributed to image acquisition, analysis, and manuscript revision; Hadam J, Bham NS, and Sobani ZA contributed to the study's conception, supervision, and critical review; and all authors have read and approved the final version of the study for publication.
AI contribution statement: The authors take full responsibility and accountability for all content in this manuscript. No portion of the manuscript was created using AI tools as assistive technologies. Specifically, AI tools were not used to generate scientific data, perform independent scientific analyses, draw scientific conclusions, write up the manuscript, or create tables or figures.
Informed consent statement: Written informed consent was obtained from the patient prior to enrollment for publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Zain A Sobani, Assistant Professor, Department of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506, United States. zsobani@gmail.com
Received: April 22, 2026 Revised: June 6, 2026 Accepted: August 5, 2026 Published online: December 7, 2026 Processing time: 176 Days and 10.2 Hours
Abstract
BACKGROUND
Dumping syndrome (DS), initiated by rapid gastric emptying leading to gastrointestinal and vasomotor symptoms, is a known complication of gastric surgery. While this is well recognized after gastric surgery procedures, it tends to be underrecognized after fundoplication. Recommended pharmacotherapy for DS has had varying responses. We present a case of post-fundoplication DS successfully treated with tirzepatide, a dual glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic peptide agonist.
CASE SUMMARY
We report a case of a 36-year-old female who developed hunger pain, diarrhea, and fatigue 6 months after a laparoscopic herniorrhaphy with fundoplication for hiatal hernia (HH) and gastroesophageal reflux disease. These symptoms developed while her reflux symptoms were concurrently improving. Physical examination, routine laboratory tests, imaging, and upper endoscopy were unremarkable. Esophagogastroduodenoscopy with wireless pH monitoring showed an intact fundoplication without HH, and her pH study showed significantly improved acid parameters compared with those prior to surgery. A nuclear gastric emptying study showed 50% emptying at 30 minutes and 90% at 54 minutes, consistent with DS. Tirzepatide therapy, initiated for the management of concomitant obesity, incidentally led to the resolution of DS symptoms. The subsequent discontinuation of tirzepatide, after achieving her weight goal, resulted in the recurrence of symptoms. Considering this, the patient was restarted on tirzepatide, and she is clinically doing well.
CONCLUSION
Our case highlights DS as a potential complication of fundoplication and offers insight into GLP-1-based therapies for refractory DS.
Core Tip: This report discusses a case of post-fundoplication dumping syndrome (DS), an underrecognized complication of para-esophageal herniorrhaphy, treated with tirzepatide. While an exaggerated incretin response can induce DS, glucagon-like peptide-1 (GLP-1) receptor and glucose-dependent insulinotropic peptide receptor agonists have demonstrated benefits in treating refractory cases. Our case underscores the importance of recognizing post-fundoplication DS and the potential of GLP-1-based therapies for refractory cases. Our patient’s symptoms recurrence during tapering, despite stable weight, highlights tirzepatide’s pharmacological potential in DS. This represents one of the first reported uses of tirzepatide post-fundoplication, resulting in DS resolution.
