Gastric dumping syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Template:Search infobox Gastric dumping syndrome, or rapid gastric emptying, happens when the lower end of the small intestine, the jejunum, fills too quickly with undigested food from the stomach. "Early" dumping begins during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types.

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".

Causes

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).[2]

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.

Diagnosis

Doctors diagnose dumping syndrome primarily on the basis of symptoms in patients who have had gastric surgery. Tests may be needed to exclude other conditions that have similar symptoms. Nuclear gastric emptying studies can be useful in the diagnosis of rapid gastric emptying and helpful in assessing a patient's response to therapy.

Treatment

Dumping syndrome is largely avoidable by avoiding certain foods which are likely to cause it, therefore having a balanced diet is important. Treatment includes changes in eating habits and medication. People who have gastric dumping syndrome need to eat several small meals a day that are low in carbohydrates, especially omitting simple sugars (candy, desserts, ice cream), and should drink liquids between meals, not with them. People with severe cases take medicine such as cholestyramine or proton pump inhibitors (such as pantoprazole) to slow their digestion. Doctors may also recommend surgery.