Dumping Syndrome

Dumping Syndrome

Pathogenesis. This is an increasingly rare disorder because of the rarity of the necessity for surgery in the treatment of ulcer disease. It was far more common in the past, when vagotomy and gastric resection were performed to treat severe ulcer disease.

Dumping syndrome is caused by two phenomena. First, there is the rapid release of hypertonic chyme into the duodenum, which acts as an osmotic draw into the duodenum, causing intravas- cular volume depletion. Next, there is a sudden peak in glucose levels in the blood because of the rapid release of food into the small intestine. This is followed by the rapid release of insulin in response to this high glucose level, which then causes hypoglycemia to develop.

Clinical Presentation. Patients present with sweating, shaking, palpitations, and lightheaded- ness shortly after a meal.

Treatment. There is no cure for dumping syndrome. The management is to eat multiple, small meals.