Dumping Syndrome

Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.

Clinically significant dumping syndrome occurs in approximately 10% of patients after any type of gastric surgery and in up to 50% of patients after laparoscopic Roux-en-Y gastric bypass. Dumping syndrome has characteristic alimentary and systemic manifestations. It is a frequent complication observed after a variety of gastric surgical procedures, such as vagotomy, pyloroplasty, gastrojejunostomy, and laparoscopic Nissan fundoplication. Dumping syndrome can be separated into early and late forms, depending on the occurrence of symptoms in relation to the time elapsed after a meal. Dumping syndrome has two forms, based on when symptoms occur:
• early dumping syndrome—occurs 10 to 30 minutes after a meal
• late dumping syndrome—occurs 2 to 3 hours after a meal

Symptoms:

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Flushing
• Dizziness, lightheadedness
• Rapid heart rate

Diagnosis:

• Medical history and evaluation: Your doctor can often diagnose dumping syndrome by taking a medical history, particularly if you've had stomach surgery, and evaluating your signs and symptoms.
• Blood sugar test: Because low blood sugar is sometimes associated with dumpinsyndrome, your doctor may order a test (oral glucose tolerance test) to measure your blood sugar level at the peak time of your symptoms to help confirm the diagnosis.
• Gastric emptying test: A radioactive material is added to food to measure how quickly food moves through your stomach.

Treatment:

Medications For people with severe signs and symptoms unrelieved by dietary changes, doctors prescribe octreotide (Sandostatin) in rare cases. This anti-diarrheal drug, taken by injection under the skin (subcutaneously), can slow the emptying of food into the intestine. Possible side effects include nausea, vomiting and stomach upset. Surgery Doctors use a number of surgical procedures to treat difficult cases of dumping syndrome that are resistant to more conservative approaches. Most of these operations are reconstructive techniques, such as reconstructing the pylorus, or they're intended to reverse gastric bypass surgery.

Statistics:

The incidence and severity of symptoms in dumping syndrome are related directly to the extent of gastric surgery. An estimated 25-50% of all patients who have undergone gastric surgery have some symptoms of dumping. However, only 1-5% are reported to have severe disabling symptoms.