Oct 18, 2016

Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management

Obesity Reviews : an Official Journal of the International Association for the Study of Obesity
A P van BeekJ Tack

Abstract

Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms. Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia. Clinical recommendations are needed for the diagnosis and management of dumping syndrome. A systematic literature review was performed through February 2016. Evidence-based medicine was used to develop diagnostic and management strategies for dumping syndrome. Dumping syndrome should be suspected based on concurrent presentation of multiple suggestive symptoms after upper abdominal surgery. Suspected dumping syndrome can be confirmed using symptom-based questionnaires, glycemia measurements and oral glucose tolerance tests. First-line management of dumping syndrome involves dietary modification, as well as acarbose treatment for persistent hypoglycemia. If these approaches are unsuccessful, somatostatin analogues should be ...Continue Reading

Mentioned in this Paper

Stomach Stapling
Oral Glucose Tolerance Test
Fluid Shifts
Diet
Food
Small Intestinal Wall Tissue
Esophageal Diseases
Dumping Syndrome
Acarbose
Glucose Tolerance Test

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