Dumping syndrome

Dumping syndrome: causes, symptoms and treatment methods

Dumping syndrome is a condition that occurs in patients who have undergone extensive gastrectomy, especially in the Billroth-P modification. This syndrome can manifest itself as either early or late dumping syndrome, each with its own characteristics and symptoms.

Early dumping syndrome is observed in most patients in the immediate postoperative period, and in the long term it occurs in 30% of patients in mild cases and in 10% in severe cases. The incidence of dumping syndrome depends on the type of gastric surgery performed. The most pronounced syndrome is observed after resection according to Billroth-P, less pronounced - after resection according to Billroth-I, and the least pronounced - after vagotomy with stomach drainage operations.

The cause of dumping syndrome is the rapid entry of unprocessed food with high osmolarity into the upper small intestine. This leads to the movement of extracellular fluid into the intestinal lumen, stretching of the intestinal wall and the release of biologically active substances such as histamine, serotonin and kinins. As a result of these processes, there is a decrease in the total circulating blood volume, vasodilation and increased intestinal motility.

Symptoms of dumping syndrome may appear 10-15 minutes after eating food, especially sweet and dairy products. These may include weakness, dizziness, headache, pain in the heart, palpitations, profuse sweating and a feeling of heat. Patients may also experience bloating and epigastric pain, rumbling, colicky pain and diarrhea.

With severe dumping syndrome, patients are forced to take a horizontal position after eating. For diagnosis, clinical symptoms are used, as well as x-ray examination of the passage of a radiopaque food mixture through the gastrointestinal tract.

Late dumping syndrome, also known as hypoglycemic syndrome, develops approximately 2-3 hours after eating. It is associated with excess insulin release during the early dumping response, which is accompanied by an increase in blood sugar levels. Increased insulin release leads to a decrease in sugar levels to hypoglycemia. Symptoms of late dumping syndrome include weakness, sweating, dizziness, hunger, anxiety, drowsiness, tremors, pale skin and palpitations.

Treatment of dumping syndrome includes several approaches. One of them is diet therapy, which includes limiting the consumption of fast carbohydrates such as sugar, sweets and juices. It is recommended to increase your intake of protein and complex carbohydrates such as vegetables, low glycemic fruits and whole grains. It is also recommended to eat small portions of food and have frequent meals.

If the effect of diet therapy is insufficient, medications may be used. For example, medications that slow gastric emptying can help slow the rate of digestion and prevent food from moving quickly into the intestines. Drugs that reduce insulin production may also be used to prevent hypoglycemia.

In some cases, when conservative methods are ineffective, surgery may be required. For example, performing the Billroth P reversal procedure may help eliminate the symptoms of dumping syndrome in some patients.

It is important to consult a doctor for diagnosis and development of an individual treatment plan if dumping syndrome is suspected. It will be based on your symptoms and the results of additional tests.