Gastric dumping syndrome

Under the dumping syndrome is a so-called fall emptying of liquid and solid food from the stomach into the small intestine and its consequences. The term derives from the English word "to dump" for " plop ", whereby the disease is described vividly.

  • 4.1 General measures
  • 4.2 drugs
  • 4.3 Surgical options

Etiology ( causes)

Responsible for the development of dumping syndrome, a disorder of the reservoir function of the stomach, which requires that the contents of the stomach may empty too fast. In most cases, the dumping syndrome occurs after operations in which the pylorus ( pylorus ) was removed, such as after a Gastric Bypass surgery, Billroth or a Whipple operation.

Forms and their clinical

Early dumping

Because the food is not long enough remains in the stomach, there is here no pre-digestion, the chyme passes practically unchanged in the small intestine. This hyperosmolar mass leads firstly to a non-physiological strain of the intestinal wall, but also by their hyperosmolarity, to a massive influx of fluid into the small intestine. The consequence of this is vasomotor disturbances, such as a drop in blood pressure, up to the collapse. The Early dumping occurs immediately after eating.

Late dumping

Due to the lack of pre-digestion reach water-soluble carbohydrates ( ie sugar) in the small intestine are absorbed here and let the blood sugar to rise quickly strong. The pancreas responds to this with a strong release of insulin. After the sugar has been digested, insulin is left, which leads to hypoglycemia, etc., with their typical symptoms of dizziness, tremors, palpitations. Symptoms of late dumping usually show up a few hours after ingestion.

Diagnostics

Most patient history and a determination of blood glucose levels is leading the way. In rare cases, a nuclear medicine study provide further evidence.

Therapy

General measures

  • Slow Food
  • Frequent, small meals
  • Drink little to eat
  • In the case of a percutaneous endoscopic gastrostomy ( PEG): Feed on a food pump over 24 h

Drugs

  • Beta blocker
  • Anticholinergics
  • Sedatives

Surgical Options

In severe, refractory cases may possibly a conversion of Billroth II to Billroth I help ( to Henley - Soupault ).

References

  • Kloeters and Müller; Crash Course Surgery, 2004 edition
  • Biesalski, H.K. et al.; Nutritional Medicine; Thieme Verlag, 1999
  • Disease in gastroenterology
Syncope (medicine)
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