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Dumping Syndrome
Published in Charles Theisler, Adjuvant Medical Care, 2023
Dumping syndrome is a group of symptoms such as bloating, nausea, diarrhea, dizziness, weakness, sweating, and rapid heartbeat after eating. Dumping syndrome most frequently occurs in patients who have undergone major gastric or esophageal surgery. Symptoms are due to rapid emptying of the stomach contents into the duodenum that can result in stomach cramps, nausea, and diarrhea. This may occur as quickly as 30 to 60 minutes after eating a meal, but can also occur as late as two to three hours after eating.
Endocrinology
Published in Paul Bentley, Ben Lovell, Memorizing Medicine, 2019
Dumping syndrome: Frequent small snacks of complex carbohydrateDietary fibre, guar gum, acarbose
Surgery for Severe Obesity
Published in James M. Rippe, Lifestyle Medicine, 2019
Robert F. Kushner, Lisa A. Neff
Patients with symptoms of dumping syndrome can usually be managed by dietary modification, including avoidance of concentrated sweets and simple sugars, consumption of small frequent meals, and inclusion of protein at every meal. Patients with symptoms suggestive of postprandial hypoglycemia that are not ameliorated by dietary modification should undergo evaluation for the presence of endogenous (or “post-bypass”) hyperinsulinemic hypoglycemia.10,48 Patients with more severe neuroglycopenic symptoms (such as confusion or loss of consciousness) should also undergo evaluation for this condition, which can occur after gastric bypass. For most patients with post-bypass hypoglycemia, dietary modification, including carbohydrate restriction to less than 30 grams per meal, can significantly reduce the frequency and severity of symptoms.49 However, when symptoms persist, pharmacologic therapies, such as acarbose, diazoxide, somatostatin analogs, and calcium channel blockers, may be required.
Oral Nutritional Supplementation Following Upper Gastrointestinal Cancer Surgery: A Prospective Analysis Exploring Potential Barriers to Compliance
Published in Journal of the American College of Nutrition, 2020
Irene Lidoriki, Dimitrios Schizas, Konstantinos S. Mylonas, Maximos Frountzas, Aikaterini Mastoraki, Emmanouil Pikoulis, Theodoros Liakakos, Ioannis Karavokyros
Malnutrition is common in oncologic patients due to the debilitating nature of their disease (1). Chemotherapy and radiation treatment can further aggravate nutritional deficiencies (2). In upper gastrointestinal (GI) cancer, malnutrition is also related to tumor location as these lesions tend to mechanically obstruct normal oral intake (3). Malnutrition occurs in 60–85% of patients with upper GI malignancies (4–6) while as many as 33% experience involuntary weight loss (at least 15%) in the first 3 years following surgical intervention (7, 8), highlighting the importance of timely nutritional consultation and support in this population. The main problems patients encounter postoperatively are premature satiety, anorexia, dysphagia, reflux, and postprandial dumping syndrome (9). In a survey of gastric cancer patients after gastrectomy, the incidence of at least one symptom of early dumping syndrome was greater than 60%, whereas the incidence of late dumping syndrome was ∼50% (10). Moreover, dumping syndrome, diarrhea or regurgitation persisted for more than 10 years in 33% of patients who underwent esophagectomy (11).
Long-Term Nutritional Outcome and Health Related Quality of Life of Patients Following Esophageal Cancer Surgery: A Meta-Analysis
Published in Nutrition and Cancer, 2018
Trang Thuy Soriano, Guy D. Eslick, Thiru Vanniasinkam
Despite similarities in the overall quality of life scores to reported general population, patients' gastrointestinal symptom scores are significantly worse and continue for an extended period after surgery. Esophagectomy is a complex procedure and involves resection of the proximal one third to half of the stomach as well as at least two thirds of the esophagus. Gastro-intestinal continuity is created by using the remnant stomach as a conduit, it is “pulled up” into the chest and anastomosed to the proximal esophagus (2,8). The surgery often results in a number of postoperative nutrition impact symptoms. Common symptoms described include appetite loss, diarrhea, eating problems, reflux, taste problems, vomiting and nausea, and dumping syndrome. These symptoms are attributed to the extensive anatomical changes as a result of surgery, the reconstruction of the upper gastrointestinal tract, the division of the vagal nerve, and the absence of the esophageal sphincter. Several studies report symptoms commonly at 6 months and long term studies report that these symptoms can persists after many years. For example, the longest study period looking at nutrition impact symptoms or gastrointestinal symptoms was 10 years post esophagectomy. At 3 years or greater after surgery, patient still reported gastrointestinal symptoms such dysphagia, diarrhea, nausea, reflux, and dumping syndrome.
OverStitch Sx Endoscopic suturing system in minimally invasive endoscopic procedures: overview of its safety and efficacy and comparison to oversticthTM
Published in Expert Review of Medical Devices, 2022
Tara Keihanian, Mohamed O Othman
Dilated gastric pouch post Roux-en-Y gastric bypass not only leads to weight gain, it is also associated with accelerated pouch emptying and dumping syndrome. OverStitch can be used to limit the pouch size for both bariatric intension and for symptomatic relief in those with dumping syndrome. 14 patients with significant dumping syndrome post Roux-en-Y gastric bypass underwent pouch reduction with OverStitch, 13 of the 14 patients did not experience further symptoms related to dumping syndrome 1 month post procedure and all patients had regular emptying of gastrografin upper gastrointestinal series [65]