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Gastroenterology (Expert Forum)
Re: dumping syndrome
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Re: dumping syndrome
by HFHSM.D.-rf, Jan 01, 1995 12:00AM
Posted By HFHSM.D.-rf on April 19, 1998 at 11:37:02:
In Reply to: dumping syndrome posted by george dotts on April 11, 1998 at 10:32:12:
Searching for references on dumping syndrome. Dietary options,
nutritional concerns and anything related to controlling this
problem. Cause : surgery which removed a large part of the
stomach and relocated the attachment to the intestine. This was
not cancer related, a recurranance of ulcer problems excaberated
the constriction from previous scarring and perforated the wall
between the stomach and gall bladder. Have little luck finding
any material related to this condition. My wife's GP is trying to
help but he also laments the lack of information. We have tried
many diet variations (content, quantity and timing) to no avail.
We are medically literate so technical journals or references are
welcome. Thanks for any help you can provide.
George and Patricia Dotts
_____
Dear George and Patricia Potts,
The technical term for your surgery is subtotal gastrectomy with Bilroth II anastomosis to reestablish the continuity of the gastrointestinal tract. This procedure is commonly performed for treatment of complicated peptic ulcer disease. There are several expected results of removing a portion of the stomach. Under normal physiologic conditions, the stomach and pylorus (the opening of the stomach into the small bowel) control the rate at which gastric contents leave the stomach. After gastric resection, patients can develop abdominal bloating, pain, vomiting, and vasomotor symptoms (flushing, sweating, rapid heart rate, light headedness). Finally, some patients have diarrhea.. These problems are due to rapid gastric emptying causing bowel distention plus movement of fluid from the blood to the intestine to dilute the intestinal contents. These symptoms usually occur 30-60 minutes after eating and are called the early dumping syndrome.
A number of lifestyle modifications have been suggested as the initial treatments of dumping syndrome. Recumbency after eating slows gastric emptying and may improve the dumping symptoms, although heartburn may be an unanticipated side effect. Eating smaller meals but more frequently has also been a mainstay of therapy. Restricting simple carbohydrates( e.g. glucose, disaccharides), eating more protein, and not drinking liquids during a meal can reduce the symptoms of dumping syndrome. Eating complex viscous carbohydrates such as pectins, guar is encouraged because these compounds slow gastric emptying and thereby diminishes symptoms. These techniques along with adaptation of the gastrointestinal tract improve the dumping syndrome in the majority of cases. Only 10% of patients with gastric resection experience incapacitating dumping problems. In these cases, treatment with the medication Octreotide (somatostatin) has improved symptoms. This medication must be administered several times per day by subcutaneous injection, a feature that makes treatment less appealing to some patients..
There is also a late dumping syndrome. This term refers to symptoms of weakness, somnolence, sweating that occur approximately 2 hours after eating and are the result of low blood sugars.
One reason why your physician is having difficulty obtaining information regarding information on dumping syndrome, is that the problem is becoming less prevalent. The number of operations for ulcer disease is diminishing as treatment of ulcer patients for H. pylori infection reduces the number of ulcer recurrences and possible complications.
As a first step of therapy, I would suggest that you arrange consultation with a dietician to receive information regarding specific foods that should be eaten and which foods should be avoided. You may receive a detailed diet as well as specific recipes. If you are still having problems and wish to be seen at Henry Ford Health System, I suggest that you be evaluated by Dr. Muszkat of the Division of Gastroenterology. In addition to being a board certified gastroenterologist, he is also certified in nutrition. He is very helpful and I am certain that you would be comfortable working with him. If you wish to be seen by Dr. Muszkat, please call (313) 876-2393 to arrange an appointment.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by a physician.
Best of luck.
HFHSM.D.-rf
*keywords: peptic ulcer surgery, subtotal gastrectomy, dumping syndrome, Octreotide
0.6
In Reply to: dumping syndrome posted by george dotts on April 11, 1998 at 10:32:12:
Searching for references on dumping syndrome. Dietary options,
nutritional concerns and anything related to controlling this
problem. Cause : surgery which removed a large part of the
stomach and relocated the attachment to the intestine. This was
not cancer related, a recurranance of ulcer problems excaberated
the constriction from previous scarring and perforated the wall
between the stomach and gall bladder. Have little luck finding
any material related to this condition. My wife's GP is trying to
help but he also laments the lack of information. We have tried
many diet variations (content, quantity and timing) to no avail.
We are medically literate so technical journals or references are
welcome. Thanks for any help you can provide.
George and Patricia Dotts
_____
Dear George and Patricia Potts,
The technical term for your surgery is subtotal gastrectomy with Bilroth II anastomosis to reestablish the continuity of the gastrointestinal tract. This procedure is commonly performed for treatment of complicated peptic ulcer disease. There are several expected results of removing a portion of the stomach. Under normal physiologic conditions, the stomach and pylorus (the opening of the stomach into the small bowel) control the rate at which gastric contents leave the stomach. After gastric resection, patients can develop abdominal bloating, pain, vomiting, and vasomotor symptoms (flushing, sweating, rapid heart rate, light headedness). Finally, some patients have diarrhea.. These problems are due to rapid gastric emptying causing bowel distention plus movement of fluid from the blood to the intestine to dilute the intestinal contents. These symptoms usually occur 30-60 minutes after eating and are called the early dumping syndrome.
A number of lifestyle modifications have been suggested as the initial treatments of dumping syndrome. Recumbency after eating slows gastric emptying and may improve the dumping symptoms, although heartburn may be an unanticipated side effect. Eating smaller meals but more frequently has also been a mainstay of therapy. Restricting simple carbohydrates( e.g. glucose, disaccharides), eating more protein, and not drinking liquids during a meal can reduce the symptoms of dumping syndrome. Eating complex viscous carbohydrates such as pectins, guar is encouraged because these compounds slow gastric emptying and thereby diminishes symptoms. These techniques along with adaptation of the gastrointestinal tract improve the dumping syndrome in the majority of cases. Only 10% of patients with gastric resection experience incapacitating dumping problems. In these cases, treatment with the medication Octreotide (somatostatin) has improved symptoms. This medication must be administered several times per day by subcutaneous injection, a feature that makes treatment less appealing to some patients..
There is also a late dumping syndrome. This term refers to symptoms of weakness, somnolence, sweating that occur approximately 2 hours after eating and are the result of low blood sugars.
One reason why your physician is having difficulty obtaining information regarding information on dumping syndrome, is that the problem is becoming less prevalent. The number of operations for ulcer disease is diminishing as treatment of ulcer patients for H. pylori infection reduces the number of ulcer recurrences and possible complications.
As a first step of therapy, I would suggest that you arrange consultation with a dietician to receive information regarding specific foods that should be eaten and which foods should be avoided. You may receive a detailed diet as well as specific recipes. If you are still having problems and wish to be seen at Henry Ford Health System, I suggest that you be evaluated by Dr. Muszkat of the Division of Gastroenterology. In addition to being a board certified gastroenterologist, he is also certified in nutrition. He is very helpful and I am certain that you would be comfortable working with him. If you wish to be seen by Dr. Muszkat, please call (313) 876-2393 to arrange an appointment.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by a physician.
Best of luck.
HFHSM.D.-rf
*keywords: peptic ulcer surgery, subtotal gastrectomy, dumping syndrome, Octreotide
0.6
