Dumping syndrome

[afsec9]

Yesterday, I had an episode again of having a dumping episode that seems to be diarrhea pushing a regular stool ahead of it within two hours of eating a regular full meal.  This always seems to result in abdominal bloating, moderate pain on the bottom left side of the descending colon with flushing, cold sweats, light headedness, and nausea. I was so lightheaded that I thought I was going to pass out on the toilet yesterday. This morning, I find myself passing blood with some gas in the amount of about a two tablespoons.  This happened in 2003, and the bleeding was much worse in the form of a cup or so and it continued for a few days and occured right after a dumping incident and that scared me.  I immediately went to my primary care who ordered a colonoscopy which was negative and I was referred to a proctologist who said I had internal bleeding hemorrhoids and a bleeding fissure. One internal hemorrhoid she banded. That was it as far as treatment.  I have had a few dumping incidents off and on since 2003 but without bloody stools afterwards. It seems that I still have this dumping problem every few months or so. If I look back to 1993, I realized that I have had this dumping syndrome off and on within a couple of hours after eating just like I had before I had my bad gall bladder removed in 1994.

I am 50, I have arteriosclerosis and PVD in both legs, and I take Zocor and Niacin for my cholesterol. My heart is fine, and I do not have stomach problems that I know of. My mother did have hypoglycemia, and my blood sugar appears to be fine as I have been tested for diabetes in a study when I was still in the military a few years ago in 1997. I retired after 25 years of active duty in 1998.

I feel like my primary care and the proctologist are both side tracked by the bleeding and normal colonoscopy and I would like to know why I am still having this dumping problem. I would like to get this problem resolved and I am hoping for some advice as how to proceed to get this resolved.

Thank You,

Scott

[Kevin Pho, MD]

I agree with the comments below.  Chronic mesenteric ischemia needs to be considered, especially with the history of atherosclerosis and the symptoms in relation to meals.  

The normal colonoscopy is comforting in that things like a polyp or colon cancer would be less likely.

An ultrasound would be an appropriate study to evaluate for this possibility - with a sensitivity above 90 percent.  Any suspicious findings can be followed up with an angiogram.

You can discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

Dumping syndrome, as far as I know, refers to symptoms much like yours, but which result from having had certain types of stomach surgery. In any case, given your atherosclerosis, one possibility is "intestinal angina," meaning narrowed blood vessels to the gut, which typically causes symptoms after eating. You should mention that to your doctors; it can be suspected based on abdominal doppler ultrasound studies, or, more invasively, ateriograms.