The So-Called “Dumping Syndrome” After Subtotal Gastrectomy

Custer, Monford D.; Butt, Hugh R.; Waugh, John M.

doi:10.1097/00000658-194603000-00007

Cited by 77 publications

(12 citation statements)

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“…The application of pectin in the treatment of the dumping syndrome, therefore, must be considered limited, and other ways must be found with a view to normalizing the gastric emptying. In 1946Custer et al (11) recommended that dumping patients take cream or olive oil at the beginning of each meal. In dogs (12) it has been shown that an abnormal gastric emptying of a meal after vagotomy could be normalized by consuming soya bean oil (Vitrum AB, Stockholm, Sweden) before the meal ingestion.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pectin on Gastric Emptying and Gut Hormone Release in the Dumping Syndrome

Lawaetz

Blackburn

Bloom

et al. 1983

Scandinavian Journal of Gastroenterology

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The effect of pectin on gastric emptying, gut hormone release, and symptoms was studied in four patients with dumping syndrome and in two healthy volunteers after ingestion of a hypertonic glucose meal with and without addition of pectin. The initial fraction emptied from the stomach was reduced in the patients, whose symptoms of dumping were abolished or alleviated by pectin. This change of the emptying seems to be caused by a prolonged stomach transit, probably due to the viscous nature of the pectin meal. Pectin had no effect on the gastric emptying of the volunteers. The motor activity of the stomach was not altered by pectin in either the patients or volunteers. In the patients insulin, enteroglucagon, neurotensin, and gastric inhibitory polypeptide rose to higher levels after the glucose meal than after the glucose-pectin meal. The individual differences in the hormone release were considered secondary to the altered gastric emptying produced by pectin.

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Section: Discussionmentioning

confidence: 99%

Effect of Pectin on Gastric Emptying and Gut Hormone Release in the Dumping Syndrome

Lawaetz

Blackburn

Bloom

et al. 1983

Scandinavian Journal of Gastroenterology

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“…Improved surgical outcomes have led to increased interest in the quality of life (QOL) of patients after surgical treatment. Dumping syndrome, a well-known complication of gastrectomy, is classified into early or late phases depending on the timing of symptom onset in relation to meals [2,3]. Early dumping syndrome occurs within 30 min of eating, accompanied by general symptoms such as drowsiness, fatigue, weakness, cold sweats and palpitations, either with or without abdominal symptoms including bloating, borborygmus, abdominal discomfort and diarrhea.…”

Section: Introductionmentioning

confidence: 99%

Specific Features of Dumping Syndrome after Various Types of Gastrectomy as Assessed by a Newly Developed Integrated Questionnaire, the PGSAS-45

et al. 2015

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Aim: Dumping syndrome is a well-known adverse outcome after gastrectomy, but the precise clinical features have not been described. The aim of this study was to examine global aspects of dumping syndrome and to explore factors affecting the intensity of dumping syndrome in a large cohort using a newly developed integrated questionnaire, the Post-Gastrectomy Syndrome Assessment Scale (PGSAS)-45. Methods: Eligible questionnaires retrieved from 2,368 patients after 6 types of gastrectomy were analyzed. The incidence, intensity and number of symptoms of early general, early abdominal and late dumping syndrome were examined across various types of gastrectomy, and clinical factors affecting the intensity of each category of dumping syndrome were identified by multiple regression analysis. Results: Dumping syndromes occurred most frequently and strongly in patients who underwent total gastrectomy with Roux-en-Y (TGRY), followed by proximal gastrectomy (PG), distal gastrectomy with Billroth-I, distal gastrectomy with Roux-en-Y, pylorus-preserving gastrectomy (PPG) and local resection (LR), in that order. Significant positive correlations among different categories of dumping syndromes were observed. TGRY, female sex, younger age, division of the celiac branch of the vagus nerve, PG and shorter postoperative period were independently related to worse dumping syndrome. Conclusions: Dumping syndromes were most common after TGRY and least common after PPG and LR among the various gastrectomy procedures. Type of gastrectomy and several clinical factors were related to the intensity of dumping syndrome. PGSAS-45 could offer a useful tool for evaluating dumping syndrome after gastrectomy.

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“…Many writers (Custer, Butt, and Waugh, 1946;Zollinger and Hoerr, 1947;Hobsley and Le Quesne, 1960) have suggested that carbohydrates are particularly at fault in causing the early phase of the post-gastrectomy syndrome. All our patients were asked which foods, if any, they avoided.…”

Section: Dumping Syndromementioning

confidence: 99%