Gastric dumping syndrome pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
The pathophysiological mechanisms involved in dumping syndrome are incompletely understood. Relatively few recent studies have been devoted to elucidating the mechanisms involved in early and late dumping syndromes, and much of our current knowledge is based on older literature [21]. Symptoms of early and late dumping syndrome appear to be caused by distinct pathophysiological mechanisms.
Pathophysiology
Normal digestive mechanism
- Digestion in stomach
Disruption of digestive mechanism
Pathogenesis
Provoking factors
Role of splanchnic vasodilation
Rapid emptying of stomach contents
Role of autonomic nervous system
Changes in serum glucose levels and plasma volume
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- Dumping syndrome is most common in patients with certain types of stomach surgery, such as a gastrectomy or gastric bypass surgery, that allow the stomach to empty rapidly. Dumping syndrome can also occur as a result of complications after a cholecystectomy (gallbladder removal).[1]
- Patients with Zollinger-Ellison syndrome, a rare disorder involving extreme peptic ulcer disease and gastrin-secreting tumors in the pancreas, may also have dumping syndrome.
- Dumping is also common for esophageal cancer patients who have had an esophagectomy; surgery to remove the cancerous portion of their esophagus. The stomach is pulled into the chest and attached to what remains of the esophagus, leaving a short digestive tract. Both early and late dumping syndrome can occur.
- Finally, patients with connective tissue conditions such as Ehlers-Danlos syndrome can experience "late" dumping as a result of decreased motility.
- In addition, people with this syndrome often suffer from low blood sugar, or hypoglycemia, because the rapid "dumping" of food triggers the pancreas to release excessive amounts of insulin into the bloodstream. This type of hypoglycemia is referred to as "alimentary hypoglycemia".