Contents

Search

dumping syndrome; postgastrectomy syndrome; rapid gastric emptying

Etiology: 1) gastrectomy with or without vagotomy 2) rapid gastric emptying of a large osmotic load into the small intestine Clinical manifestations: 1) abdominal discomfort, diarrhea, nausea/vomiting, bloating & borborygmi - early dumping occurs ~15-30 minutes after eating 2) vasomotor manifestations occur later within 60-90 minutes a) palpitations, tachycardia, hypotension b) sweating (diaphoresis), flushing, pallor c) dizziness, lightheadedness, fatigue [2] 3) late dumping occurs 1-3 hours after eating [2] - reactive hypoglycemia - inability to concentration, altered consciousness, faintness Management: 1) 6 small meals/day, high in protein, low in refined carbohydrates 2) avoid liquid with meals, take liquids following meals [2] 3) pectin 4) anticholinergic agents 5) ephedrine 6) subcutaneous octreotide in refractory cases

General

syndrome chronic gastrointestinal disease

References

  1. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 344
  2. Medical Knowledge Self Assessment Program (MKSAP) 14, 18, 19. American College of Physicians, Philadelphia 2006, 2018, 2021. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Berg P, McCallum R. Dumping Syndrome: A Review of the Current Concepts of Pathophysiology, Diagnosis, and Treatment. Dig Dis Sci. 2016 Jan;61(1):11-8. Review. PMID: 26396002
  4. Dumping Syndrome https://www.niddk.nih.gov/health-information/digestive-diseases/dumping-syndrome