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General Medicine

Dumping Syndrome

Hongyi Cui, MD, PhD, FACS, FICS Reviewed 06/2018
 


BASICS

DESCRIPTION

GI and vasomotor symptoms resulting from rapid gastric emptying and delivery of large amounts of hyperosmolar content into the small intestine 

  • Usually occurs following gastric and es...

DIAGNOSIS

HISTORY

  • Dumping syndrome is a clinical diagnosis based on typical symptoms following gastric surgery.

  • History of gastric or esophageal surgery

  • Early dumping symptoms are primarily GI.

  • Late dumpi...

TREATMENT

  • Dietary modification is the mainstay of treatment.

    • Low-carbohydrate, high-protein diet

    • Add dietary fiber.

    • Avoid milk and milk products.

    • Frequent small meals with minimal liquid.

    • Drink liquids bet...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Lying supine for 30 minutes after eating or when symptoms occur reduces the incidence of syncope. 

Patient Monitoring

Ensure adequate nutrition. 

DIET

Mainstay of tre...

REFERENCES

1
Tzovaras G, Papamargaritis D, Sioka E, et al. Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy. Obes Surg.  2012;22(1):23–28...

ADDITIONAL READING

  • Banerjee A, Ding Y, Mikami DJ, et al. The role of dumping syndrome in weight loss after gastric bypass surgery. Surg Endosc.  2013;27(5):1573–1578.

  • Dikic S, Randjelovic T, Drago...

SEE ALSO

  • Diarrhea, Chronic; Hypoglycemia, Nondiabetic; Peptic Ulcer Disease

  • Algorithm: Diarrhea, Chronic

CODES

ICD10

K91.1 Postgastric surgery syndromes 

ICD9

564.2 Postgastric surgery syndromes 

SNOMED

  • 80193009 Postgastric surgery syndrome (disorder)

  • 235666009 Early dumping syndrome

  • 235667000 Late dumping synd...

CLINICAL PEARLS

  • Dumping syndrome is a well-known but underrecognized complication of upper GI tract surgery.

  • Dumping syndrome is the most common cause for emergency room presentation after bariatric su...

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Related Images
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Fig GI 10-10 Peptic ulcer disease. (A) Large incisura (black arrow) simulating a filling defect on the greater curvature. The incisura is incited by a long ulcer (white arrows) on the lesser curvature. (B) Double pylorus. The true pylorus and the accessory channel along the lesser curvature are separated by a bridge, or septum, that produces the appearance of a discrete lucent filling defect (arrow).
Fig GI 10-10 Peptic ulcer disease. (A) Large incisura (black arrow) simulating a filling defect on the greater curvature. The incisura is i...
Fig GI 10-10 Peptic ulcer disease. (A) Large incisura (black arrow) simulating a filling defect on the greater curvature. The incisura is incited by a long ulcer (white arrows) on the lesser curvature. (B) Double pylorus. The true pylorus and the accessory channel along the lesser curvature are separated by a bridge, or septum, that produces the appearance of a discrete lucent filling defect (arrow).
Fig GI 10-10 Peptic ulcer disease. (A) Large incisura (black arrow) simulating a filling defect on the greater curvature. The incisura is i...
Gastric ulcer. The stomach has been opened to reveal a sharply demarcated, deep peptic ulcer on the lesser curvature.
Gastric ulcer. The stomach has been opened to reveal a sharply demarcated, deep peptic ulcer on the lesser curvature.
Duodenal ulcer. A sharply punched-out peptic ulcer of the duodenum is situated immediately below the pylorus.
Duodenal ulcer. A sharply punched-out peptic ulcer of the duodenum is situated immediately below the pylorus.
Figure 15-14 Perforated peptic ulcer of stomach.
Figure 15-14 Perforated peptic ulcer of stomach.
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