Causative & risk factors
Dumping syndrome most commonly occurs as a result of stomach surgery, where anatomic changes have been made. It occurs when a portion of the stomach is removed (gastrectomy) or if gastric bypass (gastroenterostomy or gastrojejunostomy) has been carried out. Dumping syndrome can also occur after removal of the esophagus (esophagectomy) or after cutting a part of the vagus nerve (vagotomy).
Pre-existing diseases such as diabetes and Zollinger-Ellison syndrome increase your risk of developing Dumping syndrome.
Clinical presentation
Dumping syndrome gives rise to symptoms like pain and distension of the abdomen, nausea, vomiting and diarrhea soon after a meal. The patient may start feeling dizzy, lightheaded and develop palpitations.
Due to rapid emptying of a large amount of food into the intestines, the insulin metabolism gets affected and there is dip in the blood sugar levels 1 to 3 hours after the meal. During this phase, the patient can become dizzy, have increased heart rate and develop palpitations. He starts sweating excessively and feels very hungry. He may even faint.
Investigations
The doctor will first evaluate the patient’s symptoms carry out a physical exam.
Gastric emptying test is carried out to confirm Dumping syndrome. In this procedure, a radioactive material is added to food and then the movement of the food through the stomach is assessed.
An oral glucose tolerance test is done.
Treatment
Making changes in the diet is a simple and effective way of treating Dumping syndrome.
The patient is advised to eat several small meals through the day. Liquids must be avoided during or soon after a meal. High-glycemic index foods which cause a sudden spike in the blood sugar levels must be avoided. The fiber and protein content of the meals must be increased and acidic food should be avoided. It is advisable to consult a dietician to plan the patient’s diet.
When lifestyle measures do not work, certain medications are prescribed to the patient to relieve the symptoms. These include anti-diarrheal drugs and drugs to delay the digestion of carbohydrates.
Surgical intervention may be necessary in some people where conservative measures do not work.
