Dumping syndrome

Dumping syndrome develops after gastric surgery in up to 50% of cases, with up to 10% having significant symptoms

Dumping syndrome can be divided into early and late:
  • Early dumping syndrome 
    • Occurs 10 to 30 minutes after eating
    • Symptoms
      • Vasomotor symptoms 
        • Palpitations
        • Sweating 
        • Weakness 
      • Gastrointestinal symptoms 
        • Bloating
        • Cramping 
        • Diarrhoea 
    • Thought to be due to rapid emptying of hypermosmolar stomach contents into the small bowel, causing fluid shift from extravascular space into the intestinal lumen 
    • accounts for 75% of dumping syndrome
  • Late dumping syndrome
    • Occurs 2 to 4 hours after eating
    • Symptoms
      • Sweating 
      • Palpitations
      • Confusion
      • Occasionally syncope
    • Thought to be due to reactive hypoglycaemia 
    • Diagnosis may be confirm by frequent blood samples after an oral glucose challenge 

  • Reduction of carbohydrate intake 
  • ? octreotide in severe cases

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