Dumping Syndrome in Children

Kneepkens, C. M. F.; Fernandes, J.; Vonk, Roelf

doi:10.1111/j.1651-2227.1988.tb10643.x

Cited by 30 publications

(9 citation statements)

References 20 publications

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“…A previous study proposed that a decrease of >108 mg/dL (6 mmol/L) between peak and nadir blood glucose levels be considered diagnostic of dumping syndrome. 12 Approximately 73.3% (11/15) of the patients in the PPH group in the NICU met this criterion, compared with 12.2% (6/49) in the non-PPH group ( P < .0005). In other units, 61.1% (11/18) in the PPH group met this criterion, compared with 21.4% (30/140) in the non-PPH group ( P = .001).…”

Section: Resultsmentioning

confidence: 93%

Postoperative Surveillance and Detection of Postprandial Hypoglycemia after Fundoplasty in Children

Calabria

Gallagher

Simmons

et al. 2011

The Journal of Pediatrics

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Objective To evaluate the prevalence of postprandial hypoglycemia (PPH) after fundoplasty after the initiation of a universal postoperative glucose surveillance plan in the neonatal intensive care unit (NICU). Study design This was a retrospective chart review of children (newborn to 18 years) who underwent fundoplasty at The Children’s Hospital of Philadelphia during the 2-year-period after the launch of a surveillance protocol in the NICU and other units. The rate of screening, frequency of PPH (postprandial blood glucose <60 mg/dL [3.3 mmol/L] on 2 occasions), frequency of postprandial hyperglycemia preceding PPH, timing of PPH presentation, and related symptoms were evaluated. Results A total of 285 children were included (n = 64 in the NICU; n = 221 in other units). Of the children screened in all units, 24.0% showed evidence of PPH, compared with 1.3% of unscreened children. Hyperglycemia preceded PPH in 67.7% (21/31) of all screened children. Within the NICU, most children had PPH within 1 week, but only 53.3% exhibited symptoms of dumping syndrome. Conclusions This study supports the use of universal postoperative blood glucose surveillance in identifying PPH in children after fundoplasty. Earlier identification of PPH would lead to earlier treatment and minimize the effects of unidentified hypoglycemic events.

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Section: Resultsmentioning

confidence: 93%

Postoperative Surveillance and Detection of Postprandial Hypoglycemia after Fundoplasty in Children

Calabria

Gallagher

Simmons

et al. 2011

The Journal of Pediatrics

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“…A number of studies have evaluated the use of supplements that increase food viscosity, such as guar gum, pectin and glucomannan, in patients with dumping syndrome 45 , 100 – 106 (Table 2 ). The rationale is that the increased consistency of the meal will slow the release of nutrients to the small intestine.…”

Section: Treatmentmentioning

confidence: 99%

International consensus on the diagnosis and management of dumping syndrome

Arts²,

et al. 2020

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Dumping syndrome is a frequent complication of cancer and non-cancer oesophageal and gastric surgery, as well as bariatric surgery (also known as metabolic surgery). These interventions change gastric anatomy and innervation, which can enable a considerable amount of undigested food to reach the small intestine too rapidly 1-4. Dumping syndrome comprises a constellation of symptoms that can be subdivided into early and late dumping syndrome symptoms, which can occur jointly or separately 1-8. Typically, symptoms of early dumping syndrome occur within the first hour after a meal and include gastrointestinal symptoms (abdominal pain, bloating, borborygmi, nausea and diarrhoea) and vasomotor symptoms (flushing, palpitations, perspiration, tachycardia, hypotension, fatigue, desire to lie down and, rarely, syncope) 1,2. The underlying mechanisms might involve osmotic effects, peptide hormone release and autonomic neural responses 1. Symptoms of late dumping syndrome usually occur between 1 and 3 h after a meal and are primarily the manifestations of hypoglycaemia, which mainly results from an incretin-driven hyperinsulinaemic response after carbohydrate ingestion. Hypoglycaemia-related symptoms are attributable to neuroglycopenia (which is indicated by fatigue, weakness, confusion, hunger and syncope) and to vagal and sympathetic activation (indicated by perspiration, palpitations, tremor and irritability) 1,2. The literature has referred to late dumping syndrome as 'reactive hypoglycaemia' or, after bariatric surgery, as 'postbariatric hypoglycaemia'. However, on the basis of a common pathophysiology of rapid exposure of the small intestine to nutrients, which is also seen in early dumping syndrome (see subsequent discussion), we refer to this phenomenon as 'late dumping syndrome'. The prevalence of dumping syndrome depends on the type and extent of surgery, and on the criteria used to diagnose dumping syndrome. Dumping syndrome occurs in approximately 20% of patients undergoing

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“…zucchini, spaghetti squash) may be helpful. Asian noodles made from glucomannan can provide desired pasta flavor/texture, but it is important that these noodles be consumed with plenty of fluid, and not at bedtime, to avoid risk of obstruction [24]. Some patients find that enyzme-enriched high fiber wheat products (e.g.…”

Section: Prevention Of Hypoglycemia In Post-bariatric Patientsmentioning

confidence: 99%

Medical nutrition therapy for post-bariatric hypoglycemia: practical insights

Suhl

Anderson-Haynes

Mulla

et al. 2017

Surgery for Obesity and Related Diseases

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Hypoglycemia is increasingly recognized as a complication of bariatric surgery. Although medications are often required, medical nutrition therapy remains the key cornerstone for successful prevention of hypoglycemia in patients with post-bariatric hypoglycemia (PBH). We provide suggested approaches to the dietary management of PBH, incorporating data from both the medical literature and extensive clinical experience in an academic referral center for PBH. The overall goal of medical nutrition therapy for PBH is to reduce postprandial surges in glucose, which often trigger surges in insulin secretion and promote subsequent hypoglycemia. Thus, strategies focus on controlled portions of low glycemic index carbohydrates, avoidance of rapidly-absorbed carbohydrates, adjustment of timing of meals and snacks, and attention to personal and cultural barriers to implementation.

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Dumping Syndrome in Children

Cited by 30 publications

References 20 publications

Postoperative Surveillance and Detection of Postprandial Hypoglycemia after Fundoplasty in Children

Postoperative Surveillance and Detection of Postprandial Hypoglycemia after Fundoplasty in Children

International consensus on the diagnosis and management of dumping syndrome

Medical nutrition therapy for post-bariatric hypoglycemia: practical insights

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