Infant dumping syndrome after gastroesophageal reflux surgery

Meyer, Shirley; Deckelbaum, Richard J.; Lax, Emeric; Schiller, Medad

doi:10.1016/s0022-3476(81)80460-x

Cited by 30 publications

(13 citation statements)

References 7 publications

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“…Die Ätiologie ist multifaktoriell und noch nicht bis ins letzte geklärt. In der Literatur wird vor allem die Verkleinerung des Magens durch eine große Fundusmanschette, sowie die läsion des Nervus vagus diskutiert (6,7,9). Die Bedeutung der gestörten Sekretion von intestinalen Peptiden ist unklar, da es unmöglich scheint, Ursache und Wirkung auseinanderzuhalten (2,8,10).…”

Section: Discussionunclassified

Diagnose und Therapie des Dumping-Syndroms nach Nissen-Fundoplikation unter Berücksichtigung pathogenetischer Gesichtspunkte

Hanimann

Hirsig²

1988

Eur J Pediatr Surg

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Between 1982 and 1987 27 Nissen's fundoplications were carried out in our institution. Postoperatively 7 infants showed a typical dumping syndrome. The symptoms were irritability, pallor, sweating, tachycardia, lethargy, diarrhoea and vomiting. In all cases an absolute refusal of feeding was observed. The diagnosis was confirmed by a typical early postprandial hyperglycaemia with hyperinsulinaemia leading to a reactive hypoglycaemia. Additionally, we were able to demonstrate an increased HbA1c as an expression of recurrent hyperglycaemias in 3 infants. In 6 infants the dumping syndrome was of short duration and the symptoms disappeared after application of a so-called dumping diet. In this diet the easily resorbable carbohydrates are replaced by uncooked starch. But in one case we were forced to use continuous enteral nutrition because of persistence of the symptoms 1 year after the Nissen fundoplication. Complete refusal of feeding is an early symptom of the dumping syndrome. If this symptom is observed after a Nissen's fundoplication, a dumping syndrome must be excluded.

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Section: Discussionunclassified

Diagnose und Therapie des Dumping-Syndroms nach Nissen-Fundoplikation unter Berücksichtigung pathogenetischer Gesichtspunkte

Hanimann

Hirsig²

1988

Eur J Pediatr Surg

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“…in glycogenosis type I [1], in leucine-induced hypoglycaemia etc. We have not determined the rate of gastric emptying in our two patients, but in view of the observed postprandial hyperglycaemia and in the light of previous experience in adults [12] and infants [10,13] it is reasonable to assume that it was in fact increased after fundoplication. Whether the introduction of uncooked starch to the diet slowed gastric emptying is unknown, but precipitous emptying may have persisted.…”

Section: Discussionmentioning

confidence: 86%

“…It causes a rapid fluid shift into the lumen of the small bowel resulting in hypovolaemia, as well as rapid glucose absorption, hyperglycaemia and reactive hypoglycaemia. Reduced tolerance to oral glucose has been demonstrated in a number of infants [5,8,10,13].…”

Section: Introductionmentioning

confidence: 99%

Infant dumping syndrome: Reversal of symptoms by feeding uncooked starch

Gitzelmann

Hirsig

1986

Eur J Pediatr

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Two infants with dumping syndrome after Nissen's fundoplication were bolus-fed with regular cows' milk formula and with test meals containing either cooked or uncooked starch. Cows' milk formula and test meals made with cooked starch provoked dumping symptoms, hyperglycaemia and hyperinsulinaemia. Dumping symptoms vanished and normoglycaemia was established when meals contained uncooked starch as the sole carbohydrate. The findings suggest that uncooked starch has a place in the dietary control of dumping syndrome in infants and possibly in adults.

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“…In children, dumping syndrome seems to occur mainly after Nissen fundoplication, and our patients 3, 5, and 7 ( Table 1) are examples hereof. It is probably caused by loss of fundic volume (12), but accidental damage to the vagal nerve may also be involved (8). Dumping syndrome after anterior gastropexy has not been documented before (patient 6).…”

Section: Discussionmentioning

confidence: 99%

“…Dumping syndrome in children has been described only incidentally, almost exclusively following Nissen fundoplication (7)(8)(9)(10)(11)(12). The symptoms emerge shortly after surgery and often seem to be transient (10).…”

mentioning

confidence: 99%

Dumping Syndrome in Children

Kneepkens

Fernandes²,

Vonk³

1988

Acta Paediatrica

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Dumping syndrome is rarely seen in children. We studied ten children with symptoms following various types of gastric surgery. All had abnormal blood glucose and breath hydrogen responses after oral glucose challenge, indicating reduction of both glucose tolerance and glucose absorption, as compared to controls. Glucose tolerance was best expressed as the difference between peak and subsequent lowest blood glucose level, the upper limit of normal (mean + 3 SD) being 5.9 mmol/l. In eight children with persisting symptoms we tested the effects of glucomannan, a highly hygroscopic tasteless fibre, on glucose tolerance and glucose absorption. Glucomannan significantly improved glucose tolerance, but did have no overall effect on glucose absorption. Four children tested glucomannan added to the main meals. Breath hydrogen excretion, as established with the daytime breath hydrogen profile, decreased significantly in two, but complaints increased in three children. Glucomannan does not appear to be suitable for the treatment of dumping syndrome in children as the side effects seem to overrule the beneficial effects.

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Infant dumping syndrome after gastroesophageal reflux surgery

Cited by 30 publications

References 7 publications

Diagnose und Therapie des Dumping-Syndroms nach Nissen-Fundoplikation unter Berücksichtigung pathogenetischer Gesichtspunkte

Diagnose und Therapie des Dumping-Syndroms nach Nissen-Fundoplikation unter Berücksichtigung pathogenetischer Gesichtspunkte

Infant dumping syndrome: Reversal of symptoms by feeding uncooked starch

Dumping Syndrome in Children

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