In contemporary western society, obesity has turned into a concern. Many individuals elect to have weight-loss surgery. Patients who have undergone gastric surgery may develop a disorder known as dumping syndrome.
The rapid passage of hyperosmolar chyme from the stomach into the small intestine causes differences in gastrointestinal physiology, which have undesirable repercussions for the patient.
Epidemiology
An estimated 20-50% of patients with gastric surgery exhibit signs of the Dumping syndrome. Patients typically experience severe symptoms at a rate of 1 to 5%. Early Dumping syndrome appears to occur more frequently than late Dumping syndrome.
Anatomy
Pathophysiology
The chyme’s quick migration is most likely the origin of the dumping syndrome. In patients who have not undergone gastric surgery, digestion begins in the stomach and gradually moves to the duodenum. Food is first broken down by acid and proteases, which encourages smaller food particles to be digested in the duodenum.
When this pathway is surgically altered, this physiological mechanism is diminished. Pylorus bypass surgery or changes to gastric innervation may result in effects like a smaller stomach reserve or a quicker passage of hyperosmolar meals into the duodenum.
Early Dumping
The signs of early dumping typically appear 10 to 30 minutes after a meal. Increased volume in the small bowel results from fluid shifting from the vasculature to the intestinal lumen due to the rapid passage of hyperosmolar chyme from the stomach into the duodenum. Tachycardia, diarrhea, nausea, and abdominal cramps are considered to be brought on by this.
After meals, elevated levels of GI hormones like pancreatic polypeptide, peptide YY, enteroglucagon, vasoactive intestinal polypeptide, neurotensin, and glucagon-like peptide have been observed. Hormonal abnormalities may result in slowed motility, reduced gastric and intestinal secretions, and slowed food transit to the small bowel.
Late Dumping
After a high-carb meal, late dumping, also known as postprandial hyperinsulinemic hypoglycemia, typically takes place 1 to 3 hours later. Hypoglycemia and some conditions are related; however, the precise mechanism is unclear. It is suggested that the quick absorption of carbohydrates enhances the insulin response mediated by glucose.
Etiology
Dietary changes are an effective intervention for the majority of dumping syndrome cases. Mainly, meals should be split into smaller amounts eaten more frequently, and beverages must be saved for 30 minutes after each meal.
To make up for a reduction in carbohydrate intake, simple sugars, and dairy products should also be avoided, and protein and fat calories should be supplemented. Fiber-rich foods are recommended because they induce a longer transit time through the gut.
The extent of stomach surgery is connected to how severe dumping syndrome is. A gastrojejunostomy, pylorectomy, antrectomy, pyloroplasty, vagotomy, esophagectomy, Nissen fundoplication, and Roux-en-Y bypass are examples of surgical causes. Diabetes mellitus, viral illnesses, and idiopathic reasons are other non-surgical etiologies.
Genetics
Prognostic Factors
Dietary changes are a helpful treatment for the majority of dumping syndrome cases. The efficacy of such approaches is not well established, but the healthcare professional may suggest medicinal or surgical management if dietary changes are unsuccessful.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK470542/
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In contemporary western society, obesity has turned into a concern. Many individuals elect to have weight-loss surgery. Patients who have undergone gastric surgery may develop a disorder known as dumping syndrome.
The rapid passage of hyperosmolar chyme from the stomach into the small intestine causes differences in gastrointestinal physiology, which have undesirable repercussions for the patient.
An estimated 20-50% of patients with gastric surgery exhibit signs of the Dumping syndrome. Patients typically experience severe symptoms at a rate of 1 to 5%. Early Dumping syndrome appears to occur more frequently than late Dumping syndrome.
The chyme’s quick migration is most likely the origin of the dumping syndrome. In patients who have not undergone gastric surgery, digestion begins in the stomach and gradually moves to the duodenum. Food is first broken down by acid and proteases, which encourages smaller food particles to be digested in the duodenum.
When this pathway is surgically altered, this physiological mechanism is diminished. Pylorus bypass surgery or changes to gastric innervation may result in effects like a smaller stomach reserve or a quicker passage of hyperosmolar meals into the duodenum.
Early Dumping
The signs of early dumping typically appear 10 to 30 minutes after a meal. Increased volume in the small bowel results from fluid shifting from the vasculature to the intestinal lumen due to the rapid passage of hyperosmolar chyme from the stomach into the duodenum. Tachycardia, diarrhea, nausea, and abdominal cramps are considered to be brought on by this.
After meals, elevated levels of GI hormones like pancreatic polypeptide, peptide YY, enteroglucagon, vasoactive intestinal polypeptide, neurotensin, and glucagon-like peptide have been observed. Hormonal abnormalities may result in slowed motility, reduced gastric and intestinal secretions, and slowed food transit to the small bowel.
Late Dumping
After a high-carb meal, late dumping, also known as postprandial hyperinsulinemic hypoglycemia, typically takes place 1 to 3 hours later. Hypoglycemia and some conditions are related; however, the precise mechanism is unclear. It is suggested that the quick absorption of carbohydrates enhances the insulin response mediated by glucose.
Dietary changes are an effective intervention for the majority of dumping syndrome cases. Mainly, meals should be split into smaller amounts eaten more frequently, and beverages must be saved for 30 minutes after each meal.
To make up for a reduction in carbohydrate intake, simple sugars, and dairy products should also be avoided, and protein and fat calories should be supplemented. Fiber-rich foods are recommended because they induce a longer transit time through the gut.
The extent of stomach surgery is connected to how severe dumping syndrome is. A gastrojejunostomy, pylorectomy, antrectomy, pyloroplasty, vagotomy, esophagectomy, Nissen fundoplication, and Roux-en-Y bypass are examples of surgical causes. Diabetes mellitus, viral illnesses, and idiopathic reasons are other non-surgical etiologies.
Dietary changes are a helpful treatment for the majority of dumping syndrome cases. The efficacy of such approaches is not well established, but the healthcare professional may suggest medicinal or surgical management if dietary changes are unsuccessful.
https://www.ncbi.nlm.nih.gov/books/NBK470542/
medtigo
Dumping Syndrome
Updated :
November 9, 2022
In contemporary western society, obesity has turned into a concern. Many individuals elect to have weight-loss surgery. Patients who have undergone gastric surgery may develop a disorder known as dumping syndrome.
The rapid passage of hyperosmolar chyme from the stomach into the small intestine causes differences in gastrointestinal physiology, which have undesirable repercussions for the patient.
An estimated 20-50% of patients with gastric surgery exhibit signs of the Dumping syndrome. Patients typically experience severe symptoms at a rate of 1 to 5%. Early Dumping syndrome appears to occur more frequently than late Dumping syndrome.
The chyme’s quick migration is most likely the origin of the dumping syndrome. In patients who have not undergone gastric surgery, digestion begins in the stomach and gradually moves to the duodenum. Food is first broken down by acid and proteases, which encourages smaller food particles to be digested in the duodenum.
When this pathway is surgically altered, this physiological mechanism is diminished. Pylorus bypass surgery or changes to gastric innervation may result in effects like a smaller stomach reserve or a quicker passage of hyperosmolar meals into the duodenum.
Early Dumping
The signs of early dumping typically appear 10 to 30 minutes after a meal. Increased volume in the small bowel results from fluid shifting from the vasculature to the intestinal lumen due to the rapid passage of hyperosmolar chyme from the stomach into the duodenum. Tachycardia, diarrhea, nausea, and abdominal cramps are considered to be brought on by this.
After meals, elevated levels of GI hormones like pancreatic polypeptide, peptide YY, enteroglucagon, vasoactive intestinal polypeptide, neurotensin, and glucagon-like peptide have been observed. Hormonal abnormalities may result in slowed motility, reduced gastric and intestinal secretions, and slowed food transit to the small bowel.
Late Dumping
After a high-carb meal, late dumping, also known as postprandial hyperinsulinemic hypoglycemia, typically takes place 1 to 3 hours later. Hypoglycemia and some conditions are related; however, the precise mechanism is unclear. It is suggested that the quick absorption of carbohydrates enhances the insulin response mediated by glucose.
Dietary changes are an effective intervention for the majority of dumping syndrome cases. Mainly, meals should be split into smaller amounts eaten more frequently, and beverages must be saved for 30 minutes after each meal.
To make up for a reduction in carbohydrate intake, simple sugars, and dairy products should also be avoided, and protein and fat calories should be supplemented. Fiber-rich foods are recommended because they induce a longer transit time through the gut.
The extent of stomach surgery is connected to how severe dumping syndrome is. A gastrojejunostomy, pylorectomy, antrectomy, pyloroplasty, vagotomy, esophagectomy, Nissen fundoplication, and Roux-en-Y bypass are examples of surgical causes. Diabetes mellitus, viral illnesses, and idiopathic reasons are other non-surgical etiologies.
Dietary changes are a helpful treatment for the majority of dumping syndrome cases. The efficacy of such approaches is not well established, but the healthcare professional may suggest medicinal or surgical management if dietary changes are unsuccessful.
https://www.ncbi.nlm.nih.gov/books/NBK470542/
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