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 

Management 

• Reduction of carbohydrate intake 
• ? octreotide in severe cases

References

Kreckler, S., Dowson, H. and Willson, P. Dumping syndrome as a complication of laparoscopic Nissen fundoplication in an adult. JSLS. 2006; 10(1):94-96. 

Li-Ling, J. and Irving, M. Therapeutic value of octreotide for patients with severe dumping syndrome--a review of randomised controlled trials. Postgrad Med J. 2001; 77(909): 441-442.