Materiały źródłowe

• #1 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. […] The panel agreed on the pathophysiological relevance of rapid passage of nutrients to the small bowel, on the role of decreased gastric volume capacity and release of glucagon-like peptide 1. […] Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. […] An increase in haematocrit 3% or in pulse rate 10bpm 30min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level 50mg/dl is diagnostic of 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.

• #2 Pathophysiology, diagnosis and management of postoperative dumping syndrome | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/nrgastro.2009.148

  Dumping syndrome is a frequent complication of esophageal, gastric or bariatric surgery. […] Besides the assessment of clinical alertness and endoscopic or radiological imaging, a modified oral glucose tolerance test might help to establish a diagnosis. […] Diagnosis is based on a suggestive symptom pattern in patients with the appropriate surgical history; a modified oral glucose tolerance test might help to establish the diagnosis. […] In patients who have not responded to initial therapy, (slow-release) somatostatin analogs are the treatment of choice. […] In patients with treatment-refractory dumping syndrome, surgical reinterventions or continuous enteral feeding can be considered, but the outcomes of such approaches are variable.

• #3 Mayo Clinic Health Library – Dumping syndrome | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20371900

  Your health care provider may use some of the following methods to determine if you have dumping syndrome. […] Your doctor can often diagnose dumping syndrome by taking a medical history, particularly if you’ve had stomach surgery, and evaluating your signs and symptoms. […] Because low blood sugar is sometimes associated with dumping syndrome, your doctor may order a test (oral glucose tolerance) to measure your blood sugar level at the peak time of your symptoms to help confirm the diagnosis. […] A radioactive material is added to food to measure how quickly food moves through your stomach.

• #4 Gastric_dumping_syndrome

  https://www.bionity.com/en/encyclopedia/Gastric_dumping_syndrome.html

  Doctors diagnose dumping syndrome primarily on the basis of symptoms in patients who have had gastric surgery. […] Tests may be needed to exclude other conditions that have similar symptoms.

• #5 Dumping Syndrome: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/173594-overview

  Dumping syndrome is the effect of altered gastric reservoir function, abnormal postoperative gastric motor function, and/or pyloric emptying mechanism. […] Clinically significant dumping syndrome occurs in approximately 10% of patients after any type of gastric surgery and in up to 50% of patients after laparoscopic Roux-en-Y gastric bypass. […] The late dumping syndrome is suspected in the person who has symptoms of hypoglycemia in the setting of previous gastric surgery, and this late dumping can be proven with an oral glucose tolerance test (hyperinsulinemic hypoglycemia), as well as gastric emptying scintigraphy, which shows the abnormal pattern of initially delayed and then accelerated gastric emptying. […] The severity of dumping syndrome is proportional to the rate of gastric emptying.

• #6 Dumping syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/dumping-syndrome?lang=us

  Dumping syndrome is a common complication following gastric, bariatric or esophageal surgeries. […] Dumping syndrome occurs in approximately 12-40% of patients following Roux-en-Y gastric bypass, and up to 50% of patients following esophagectomy. […] Most cases of dumping syndrome are the early dumping syndrome type. […] Early dumping syndrome: symptom onset 30-60 minutes after eating, typically after a carbohydrate-rich meal. […] gastrointestinal symptoms: epigastric distension, nausea, vomiting, explosive diarrhea, cramping abdominal pain. […] vasomotor symptoms: flushing, dizziness, tachycardia and palpitations, hypotension. […] Postprandial hyperinsulinemic hypoglycemia (late dumping syndrome): symptom onset 1-3 hours after eating, typically after a carbohydrate-rich meal. […] hypoglycemic symptoms with Whipple triad.

• #7 Dumping Syndrome | CEG

  https://www.dovepress.com/dumping-syndrome-pragmatic-treatment-options-and-experimental-approach-peer-reviewed-fulltext-article-CEG

  Dumping syndrome consists of early and late dumping symptoms and can be diagnosed using clinical parameters with the help of the Sigstads score, questionnaires or by provocative testing. […] In patients suspected of dumping syndrome, diagnosis can be established using symptom-based scores or questionnaires and provocation tests, with scoring of both symptoms and objective parameters. […] The Sigstads score was introduced to aid diagnosis of dumping by assigning points to each of 16 typical dumping symptoms. […] The total sum of points is used to calculate a diagnostic index. A score of 7 is suggestive of dumping syndrome; a score of 4 indicates that other diagnoses should be considered. […] The occurrence of these typical systemic and abdominal postprandial symptoms in patients after bariatric or upper GI (oncological) surgery should make physicians suspect the presence of dumping syndrome.

• #8 SciELO Brazil – PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY

  https://www.scielo.br/j/abcd/a/c85MgtFzcsLqhYTrrWNpHvM/

  The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. […] Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. […] Diagnosis is done primarily through the use of questionnaires based on scores. […] The Sigstad score and Arts survey are valid means for assessing the dumping syndrome. […] The clinical diagnosis was only possible after 1970. […] Diagnostic questionnaires were created based on symptoms, such as Sigstad Score Scale and the Arts Dumping Questionnaire, to identify clinically significant symptoms. […] Sigstad scoring system is based on the occurrence of various symptoms suggestive of the syndrome. Scores greater than or equal to seven, after glucose intake, are considered diagnostic.

• #9 Dumping Syndrome | CEG

  https://www.dovepress.com/dumping-syndrome-pragmatic-treatment-options-and-experimental-approach-peer-reviewed-fulltext-article-CEG

  The Sigstads score has diagnostic value and both Sigstads and Arts scores may help to quantify the severity and impact of dumping symptoms. […] Dumping provocation tests may help to confirm the diagnosis in cases where dumping syndrome is uncertain or should be distinguished from other postprandially occurring disorders.

• #10 SciELO Brazil – PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY

  https://www.scielo.br/j/abcd/a/c85MgtFzcsLqhYTrrWNpHvM/

  The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. […] Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. […] Diagnosis is done primarily through the use of questionnaires based on scores. […] The Sigstad score and Arts survey are valid means for assessing the dumping syndrome. […] The clinical diagnosis was only possible after 1970. […] Diagnostic questionnaires were created based on symptoms, such as Sigstad Score Scale and the Arts Dumping Questionnaire, to identify clinically significant symptoms. […] Sigstad scoring system is based on the occurrence of various symptoms suggestive of the syndrome. Scores greater than or equal to seven, after glucose intake, are considered diagnostic.

• #11 Dumping Syndrome: Causes, Symptoms, Prevention, and Treatments

  https://www.webmd.com/digestive-disorders/dumping-syndrome-causes-foods-treatments

  If you had gastric surgery in the past, even if it was years ago, your doctor may be able to diagnose you by asking about your medical history and symptoms. They may give you a questionnaire called the Dumping Symptom Rating Scale to help them decide if you have dumping syndrome. […] They may also want to run tests to make sure dumping syndrome is what’s causing your symptoms, especially if you have never had gastric surgery. Some tests your doctor may order include: […] An oral glucose tolerance test. This measures your blood sugar before and after you drink a glucose solution. If your blood sugar drops 1-3 hours after you eat, this likely means you have late-phase dumping. […] A gastric emptying test. This measures how quickly food moves through your stomach. […] A hydrogen breath test. This measures hydrogen levels in your breath after you drink a glucose solution. […] An upper endoscopy. An endoscope is a thin, flexible tube with a lighted camera attached. […] An upper gastrointestinal (GI) series. In this test, you’ll drink a solution with a contrast agent in it.

• #12 American Nurse Today January 2018: Dumping Syndrome: Causes, Management, And Patient Education

  https://americannursetoday.mydigitalpublication.com/articles/dumping-syndrome-causes-management-and-patient-education

  DS occurs after 20% to 75% of all esophageal and gastric surgeries. […] Many patients with DS have symptoms similar to irritable bowel syndrome or gastroparesis (delayed gastric emptying), which can result in misdiagnosis. […] Diagnosis typically is based on clinical manifestations and the timing of the symptoms, although a few diagnostic tools can be helpful. […] The Sigstad scoring system was developed in 1970 to aid in the diagnosis of DS. […] A diagnosis of early DS is made if within 30 to 60 minutes the patient experiences a 10 beats/minute heart rate increase or the hematocrit rises 3% in the first 30 minutes. Late dumping is suspected if hypoglycemia occurs 2 to 3 hours after glucose ingestion. […] DS is diagnosed if an accelerated rate of emptying is noted. […] The Dumping Symptom Rating Scale questionnaire is reliable for detecting the severity and frequency of dumping symptoms.

• #13 Dumping Syndrome | CEG

  https://www.dovepress.com/dumping-syndrome-pragmatic-treatment-options-and-experimental-approach-peer-reviewed-fulltext-article-CEG

  The Sigstads score has diagnostic value and both Sigstads and Arts scores may help to quantify the severity and impact of dumping symptoms. […] Dumping provocation tests may help to confirm the diagnosis in cases where dumping syndrome is uncertain or should be distinguished from other postprandially occurring disorders.

• #14 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  In patients with suspected dumping syndrome, the diagnosis can be established using symptom-based questionnaires, by oral glucose challenge testing and other diagnostic investigations. […] The modified oral glucose tolerance test is the preferred diagnostic method to confirm the diagnosis of dumping syndrome, and diagnostic parameters for early dumping syndrome are well established: an increase in haematocrit 3% at 30min or an increase in pulse rate 10bpm after 30min. […] The test is considered positive if late (120-180min) hypoglycaemia occurs, or if an early (30min) increase in haematocrit level of more than 3% occurs. […] The current consensus selected 50mg/dl as a cut-off value for defining late hypoglycaemia in dumping syndrome.

• #15 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  In patients with suspected dumping syndrome, the diagnosis can be established using symptom-based questionnaires, by oral glucose challenge testing and other diagnostic investigations. […] The modified oral glucose tolerance test is the preferred diagnostic method to confirm the diagnosis of dumping syndrome, and diagnostic parameters for early dumping syndrome are well established: an increase in haematocrit 3% at 30min or an increase in pulse rate 10bpm after 30min. […] The test is considered positive if late (120-180min) hypoglycaemia occurs, or if an early (30min) increase in haematocrit level of more than 3% occurs. […] The current consensus selected 50mg/dl as a cut-off value for defining late hypoglycaemia in dumping syndrome.

• #16 Dumping Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470542/

  Dumping syndrome can occur after a variety of gastric procedures and occurs due to the rapid movement of hyperosmolar chyme from the stomach into the small intestine. […] This activity reviews the evaluation and treatment of dumping syndrome and highlights the role of the interprofessional team in the education and management of patients with this condition. […] Sigstad developed a diagnostic index for Dumping syndrome, which includes multiple signs or symptoms such as nausea, vomiting, and shock. A score of greater than seven may suggest Dumping syndrome. […] An oral glucose challenge test can trigger the signs and symptoms of Dumping syndrome. After a 50-gram oral glucose challenge following a 10-hour fast, if the patient has an elevated heart rate by ten beats or more per minute in the first hour, studies demonstrate 100% sensitivity and 94% specificity for early Dumping syndrome.

• #17 Pathophysiology, Diagnosis and Management of Postoperative Dumping Syndrome

  https://www.medscape.org/viewarticle/707838_3

  A suggestive symptom pattern in a patient who has undergone upper abdominal surgery should give cause to investigate the possibility of dumping syndrome. […] In 1970, Sigstad proposed a scoring system, based on the occurrence of different symptoms of dumping syndrome, to calculate a diagnostic index. […] The presence of hypoglycemia concurrently with several other symptoms is a strong indicator of dumping syndrome (although the occurrence of insulinoma needs to be excluded). […] A provocative test for assessing dumping syndrome can be used to confirm clinical suspicion. […] The provocative test is considered positive if late (120-180 min) hypoglycemia occurs, or if an early (30 min) increase in hematocrit of more than 3% occurs. […] The best predictor of dumping syndrome seems to be a rise in the pulse rate of more than 10 bpm after 30 min.

• #18 Dumping Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470542/

  Dumping syndrome can occur after a variety of gastric procedures and occurs due to the rapid movement of hyperosmolar chyme from the stomach into the small intestine. […] This activity reviews the evaluation and treatment of dumping syndrome and highlights the role of the interprofessional team in the education and management of patients with this condition. […] Sigstad developed a diagnostic index for Dumping syndrome, which includes multiple signs or symptoms such as nausea, vomiting, and shock. A score of greater than seven may suggest Dumping syndrome. […] An oral glucose challenge test can trigger the signs and symptoms of Dumping syndrome. After a 50-gram oral glucose challenge following a 10-hour fast, if the patient has an elevated heart rate by ten beats or more per minute in the first hour, studies demonstrate 100% sensitivity and 94% specificity for early Dumping syndrome.

• #19 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Dumping-Syndrome-Diagnosis.aspx

  Dumping syndrome (DS) can be classified as early dumping syndrome (EDS) or late dumping syndrome (LDS) based on the timing of the symptoms after eating. […] The diagnosis of both EDS and LDS is a dilemma as it involves taking into account the signs and symptoms that can be elicited after testing a patient with oral glucose, sensitive hydrogen breath tests, and endoscopy or barium swallow studies to discern the anatomy of the gastrointestinal (GI) tract. […] If the diagnosis of DS is dubious then oral glucose and hydrogen breath tests come in very handy as they have 100% sensitivity and 92% specificity. EDS symptoms can be triggered with the help of an oral glucose challenge – an increase in heart rate by 10 bpm or more following the administration of 50 grams of oral glucose after a 10-hour fast is considered diagnostic. […] The evaluation of the upper GI tract is imperative to confirm LDS because there are other conditions that may produce similar symptoms. Hence, endoscopy or barium may be used for this purpose.

• #20 Dumping Syndrome: Diagnosis, Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome

  Hydrogen breath test. This test measures hydrogen levels in your breath after you drink a glucose solution. A positive breath test for hydrogen shows that the glucose wasnt well-absorbed in your small intestine. […] Upper endoscopy. This test examines the inside of your esophagus, stomach and duodenum with an endoscope, a thin, flexible tube with a lighted camera attached. […] It can help find structural problems and other possible causes of your symptoms. […] Upper GI series. This imaging test allows healthcare providers to watch a fluid contrast solution travel through your esophagus, stomach and upper small intestine (duodenum). […] Gastric emptying test. This test measures how fast food moves through your stomach by adding a trace amount of radioactive material to your meal. Your healthcare provider will be able to watch your meal progress through your stomach on a special type of scanner.

• #21 Dumping Syndrome Workup: Approach Considerations

  https://emedicine.medscape.com/article/173594-workup

  Signs and symptoms can be elicited with the glucose challenge test (50 g oral glucose). […] A positive result from a hydrogen breath test after ingestion of glucose is also 100% sensitive. […] A gastric emptying study may be helpful to document rapid gastric emptying. […] An endoscopy or a barium study can be helpful in discerning the anatomy. […] Diagnostic value of dumping provocation in patients after gastric surgery.

• #22 Dumping Syndrome: Diagnosis, Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome

  Hydrogen breath test. This test measures hydrogen levels in your breath after you drink a glucose solution. A positive breath test for hydrogen shows that the glucose wasnt well-absorbed in your small intestine. […] Upper endoscopy. This test examines the inside of your esophagus, stomach and duodenum with an endoscope, a thin, flexible tube with a lighted camera attached. […] It can help find structural problems and other possible causes of your symptoms. […] Upper GI series. This imaging test allows healthcare providers to watch a fluid contrast solution travel through your esophagus, stomach and upper small intestine (duodenum). […] Gastric emptying test. This test measures how fast food moves through your stomach by adding a trace amount of radioactive material to your meal. Your healthcare provider will be able to watch your meal progress through your stomach on a special type of scanner.

• #23 Dumping syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Dumping_syndrome

  The health care provider may also examine the structure of the esophagus, stomach, and upper small intestine with the following tests: […] An upper GI endoscopy to see the upper GI tract. A gastroenterologist carefully feeds the endoscope down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. […] An upper GI series examines the small intestine. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the small intestine, making signs of a blockage or other complications of gastric surgery show up more clearly on x rays.

• #24 Dumping Syndrome: Diagnosis, Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome

  Hydrogen breath test. This test measures hydrogen levels in your breath after you drink a glucose solution. A positive breath test for hydrogen shows that the glucose wasnt well-absorbed in your small intestine. […] Upper endoscopy. This test examines the inside of your esophagus, stomach and duodenum with an endoscope, a thin, flexible tube with a lighted camera attached. […] It can help find structural problems and other possible causes of your symptoms. […] Upper GI series. This imaging test allows healthcare providers to watch a fluid contrast solution travel through your esophagus, stomach and upper small intestine (duodenum). […] Gastric emptying test. This test measures how fast food moves through your stomach by adding a trace amount of radioactive material to your meal. Your healthcare provider will be able to watch your meal progress through your stomach on a special type of scanner.

• #25 Dumping Syndrome: Symptoms, Causes, Complications, Treatment

  https://www.healthline.com/health/dumping-syndrome

  How is dumping syndrome diagnosed? An evaluation of your medical history and symptoms can help your doctor diagnose dumping syndrome. Additionally, the doctor may order one or more tests to make a diagnosis. These might include: […] Blood sugar test. After a doctor takes an initial blood sample, you’ll drink a glucose solution for a blood sugar test. The doctor takes another blood sample immediately after you finish the drink, and additional samples every 30 minutes for up to 3 hours. This test measures how well your body manages glucose after meals. […] Gastric emptying test. Prior to a gastric emptying test, you’ll consume a small amount of a radioactive material. Your doctor then uses a special tool to track this material through your gastrointestinal tract. The test measures how long it takes food to empty out of your stomach.

• #26 Gastric Emptying Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gastric-emptying-tests/

  When your stomach empties too rapidly (faster than normal), it may be a sign of dumping syndrome. Dumping syndrome happens when your stomach empties food too quickly into your small intestine. It is usually associated with surgery on your stomach (such as weight loss surgery) or your esophagus. […] If your results show it took a shorter-than-normal time for your stomach to empty, it could mean you have dumping syndrome.

• #27 Dumping Syndrome: Diagnosis, Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome

  Hydrogen breath test. This test measures hydrogen levels in your breath after you drink a glucose solution. A positive breath test for hydrogen shows that the glucose wasnt well-absorbed in your small intestine. […] Upper endoscopy. This test examines the inside of your esophagus, stomach and duodenum with an endoscope, a thin, flexible tube with a lighted camera attached. […] It can help find structural problems and other possible causes of your symptoms. […] Upper GI series. This imaging test allows healthcare providers to watch a fluid contrast solution travel through your esophagus, stomach and upper small intestine (duodenum). […] Gastric emptying test. This test measures how fast food moves through your stomach by adding a trace amount of radioactive material to your meal. Your healthcare provider will be able to watch your meal progress through your stomach on a special type of scanner.

• #28 Dumping Syndrome: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/dumping-syndrome-7108707

  Dumping syndrome is diagnosed based on your medical history and symptoms. You may be asked to fill out a questionnaire that assigns different points to various symptoms to help. This can help tease out whether your signs indicate dumping syndrome or another cause. […] In some cases, your healthcare provider will order further testing, which may include: […] Oral glucose tolerance test: This test requires fasting for at least 10 hours before drinking a glucose solution. Your blood sugar, hematocrit, heart rate, and blood pressure are monitored for three hours. […] Gastric emptying scan: This test involves eating a bland meal with a small amount of radioactive material. A camera outside the body scans the abdomen to track the radioactive material and see how fast your stomach empties. This test can take up to four hours. […] Upper gastrointestinal (GI) endoscopy: This test is done under sedation. A thin, flexible tube with a lighted camera is threaded through your mouth and throat to examine the esophagus, stomach, and small intestine. Tissue samples may be taken to rule out other causes of your symptoms.

• #29 Dumping Syndrome: Diagnosis, Treatment, Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome

  Hydrogen breath test. This test measures hydrogen levels in your breath after you drink a glucose solution. A positive breath test for hydrogen shows that the glucose wasnt well-absorbed in your small intestine. […] Upper endoscopy. This test examines the inside of your esophagus, stomach and duodenum with an endoscope, a thin, flexible tube with a lighted camera attached. […] It can help find structural problems and other possible causes of your symptoms. […] Upper GI series. This imaging test allows healthcare providers to watch a fluid contrast solution travel through your esophagus, stomach and upper small intestine (duodenum). […] Gastric emptying test. This test measures how fast food moves through your stomach by adding a trace amount of radioactive material to your meal. Your healthcare provider will be able to watch your meal progress through your stomach on a special type of scanner.

• #30 Dumping syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/dumping-syndrome?lang=us

  Dumping syndrome can occur as a complication of a number of gastric, bariatric, or esophageal surgical procedures, such as Roux-en-Y gastric bypass, esophagectomy, vagotomy with pyloroplasty, sleeve gastrectomy, or Nissen fundoplication. […] The pathogenesis of dumping syndrome differs between the two types: early dumping syndrome: fluid shift into small bowel lumen due to hyperosmolality of (often carbohydrate-rich) foods. […] postprandial hyperinsulinemic hypoglycemia (late dumping syndrome): exaggerated incretin response. […] In early dumping syndrome, a broad stoma and a brief transit time might be seen on barium radiographic studies. […] However, gastric emptying studies and dumping provocation test are deemed most useful investigations.

• #31 Dumping Syndrome: Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/dumping-syndrome

  Physicians perform a dumping syndrome diagnosis based on individual symptoms and the results of one or more diagnostic procedures. These may include: […] Diagnosis of dumping syndrome is complicated by the fact that symptoms overlap with those of other medical conditions. The symptoms of early dumping syndrome are often similar to those of ulcers, internal hernias, and cases of fistula, ischemia, and stenosis. Late dumping syndrome shares symptoms with hypoglycemia and related medical concerns. Medical researchers have developed a variety of diagnostic tools for correctly differentiating dumping syndrome from these other conditions.

• #32 Gastric dumping syndrome differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gastric_dumping_syndrome_differential_diagnosis

  Dumping syndrome may often be confused with other similar diseases that cause upper abdominal pain, nausea, and fatigue. […] Gastric dumping syndrome should be differentiated from other diseases presenting with nausea, vomiting, diarrhea, fatigue and abdominal pain. […] Gastric dumping syndrome should be differentiated from other diseases presenting with weight loss, vomiting, diarrhea, and abdominal pain. […] Early dumping syndrome should be differentiated from other diseases presenting with abdominal pain, vomiting, nausea and early satiety. […] Late dumping syndrome should be differentiated from other diseases presenting with hypoglycemia and nausea.

• #33 Dumping Syndrome: Updated Perspectives on Etiologies and Diagnosis – Practical Gastro

  https://practicalgastro.com/2014/10/18/dumping-syndrome-updated-perspectives-on-etiologies-and-diagnosis/

  Dumping syndrome (DS) has historically been associated with gastric surgery and vagotomy, as well as diabetes mellitus (DM). This article provides an update on the etiologies and clinical spectrum that represent the current DS patient population. […] The diagnosis of late dumping syndrome is made by the clinical presentation of late dumping symptoms and can be confirmed by an oral glucose test demonstrating low glucose levels sometimes less than 60 mg/dL at 2 or 3 hours. […] Our report highlights a patient population with a strong representation of non-surgical etiologies of DS. […] It is important to note here that our medical center does not specialize in a common cause of DS in the current era, namely bariatric surgery. […] Our expectation is that increased awareness will contribute to appropriate management and referrals for these patients, and treatments with anti-motility instead of promotility agents.

• #34

  https://link.springer.com/article/10.1007/s10620-009-0939-5

  To investigate the current incidence and identify the current etiologies of rapid gastric emptying (dumping syndrome) in patients with a spectrum of gastrointestinal symptoms, including nausea, vomiting, abdominal pain, or diarrhea. […] The results for a 4-h radionuclide gastric emptying test (GET) using a standardized scintigraphic technique were reviewed in 545 patients to see which patients met criteria for rapid gastric emptying, defined as 50% emptying of isotope-labeled solid meal at 1 h. […] Rapid gastric emptying can be identified in a sizeable subset (9%) of patients with unexplained nausea, vomiting, abdominal pain, and diarrhea when criteria are applied to the standardized scintigraphic gastric emptying meal.

• #35 Dumping Syndrome: Updated Perspectives on Etiologies and Diagnosis – Practical Gastro

  https://practicalgastro.com/2014/10/18/dumping-syndrome-updated-perspectives-on-etiologies-and-diagnosis/

  If there is uncertainty about the diagnosis, and symptoms are severe, DS should be considered. In these cases a scintigraphic study can establish the diagnosis. Treatments such as diet, dicyclomine, and octreotide, rely on an accurate diagnosis of DS. […] The utility of the scintigraphic GET. This test is key in distinguishing the diagnosis of gastroparesis from DS. […] These findings emphasize a crucial role for scintigraphic GET in patients who have the symptoms of DS, even in the absence of a recent gastric surgery. This is essential to make the diagnosis of DS and effectively treat patients with this condition.

• #36

  https://link.springer.com/article/10.1007/s10620-009-0939-5

  To investigate the current incidence and identify the current etiologies of rapid gastric emptying (dumping syndrome) in patients with a spectrum of gastrointestinal symptoms, including nausea, vomiting, abdominal pain, or diarrhea. […] The results for a 4-h radionuclide gastric emptying test (GET) using a standardized scintigraphic technique were reviewed in 545 patients to see which patients met criteria for rapid gastric emptying, defined as 50% emptying of isotope-labeled solid meal at 1 h. […] Rapid gastric emptying can be identified in a sizeable subset (9%) of patients with unexplained nausea, vomiting, abdominal pain, and diarrhea when criteria are applied to the standardized scintigraphic gastric emptying meal.

• #37 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. […] The panel agreed on the pathophysiological relevance of rapid passage of nutrients to the small bowel, on the role of decreased gastric volume capacity and release of glucagon-like peptide 1. […] Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. […] An increase in haematocrit 3% or in pulse rate 10bpm 30min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level 50mg/dl is diagnostic of 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.

• #38 International consensus on the diagnosis and management of dumping syndrome

  https://scholarworks.indianapolis.iu.edu/items/655c6da3-cb47-4768-8199-d3ca8d46ee72

  Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. […] Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. An increase in haematocrit 3% or in pulse rate 10bpm 30min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level 50mg/dl is diagnostic of late dumping syndrome.

• #39 Dumping syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dumping-syndrome/symptoms-causes/syc-20371915

  Dumping syndrome is a condition in which food, especially food high in sugar, moves from your stomach into your small bowel too quickly after you eat. […] Most people with dumping syndrome develop signs and symptoms, such as abdominal cramps and diarrhea, 10 to 30 minutes after eating. […] Generally, you can help prevent dumping syndrome by changing your diet after surgery. […] Contact your health care provider if any of the following apply to you. […] You develop signs and symptoms that might be due to dumping syndrome, even if you haven’t had surgery. […] In dumping syndrome, food and gastric juices from your stomach move to your small intestine in an uncontrolled, abnormally fast manner. […] Surgery that alters your stomach can increase your risk of dumping syndrome. […] These surgeries are most commonly performed to treat obesity, but are also part of treatment for stomach cancer, esophageal cancer and other conditions. […] Associated Procedures: Glucose tolerance test.

• #40 What causes dumping syndrome? | Roswell Park Comprehensive Cancer Center – Buffalo, NY

  https://www.roswellpark.org/cancertalk/202403/what-causes-dumping-syndrome

  When food moves too quickly from the stomach into the small intestine, it can cause uncomfortable and sometimes painful symptoms of cramping, nausea, vomiting and more. […] This condition of rapid stomach emptying called dumping syndrome can occur when your normal digestive process is altered or lost, such as when surgery for stomach or esophageal cancer alters the size, shape or position of the stomach. Rarely, dumping syndrome can happen without a surgery. […] Dumping syndrome is caused by different contributing factor, including: changing how food empties the stomach, how the nerves are distributed to the stomach, and the stimulation of gastrointestinal hormones. […] Early dumping syndrome usually gets better on its own within three months. Symptoms of late dumping syndrome usually occur several hours after eating. […] Talk with your doctor about your rapid stomach emptying symptoms, and their patterns. If symptoms are not getting better, your doctor might prescribe medicine to prevent diarrhea or suggest additional testing, such as an oral glucose challenge, upper GI series or a gastric emptying study.

• #41 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  In patients with suspected dumping syndrome, the diagnosis can be established using symptom-based questionnaires, by oral glucose challenge testing and other diagnostic investigations. […] The modified oral glucose tolerance test is the preferred diagnostic method to confirm the diagnosis of dumping syndrome, and diagnostic parameters for early dumping syndrome are well established: an increase in haematocrit 3% at 30min or an increase in pulse rate 10bpm after 30min. […] The test is considered positive if late (120-180min) hypoglycaemia occurs, or if an early (30min) increase in haematocrit level of more than 3% occurs. […] The current consensus selected 50mg/dl as a cut-off value for defining late hypoglycaemia in dumping syndrome.

• #42 Pathophysiology, Diagnosis and Management of Postoperative Dumping Syndrome

  https://www.medscape.org/viewarticle/707838_3

  A suggestive symptom pattern in a patient who has undergone upper abdominal surgery should give cause to investigate the possibility of dumping syndrome. […] In 1970, Sigstad proposed a scoring system, based on the occurrence of different symptoms of dumping syndrome, to calculate a diagnostic index. […] The presence of hypoglycemia concurrently with several other symptoms is a strong indicator of dumping syndrome (although the occurrence of insulinoma needs to be excluded). […] A provocative test for assessing dumping syndrome can be used to confirm clinical suspicion. […] The provocative test is considered positive if late (120-180 min) hypoglycemia occurs, or if an early (30 min) increase in hematocrit of more than 3% occurs. […] The best predictor of dumping syndrome seems to be a rise in the pulse rate of more than 10 bpm after 30 min.

• #43 Dumping Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470542/

  Most cases of dumping syndrome are successfully treated with dietary adjustments. The suggested division of meals recommended is at least six times per day. […] If dietary adjustments fail, the healthcare provider might recommend medical or surgical management but the success of such interventions is not well established.

• #44 Dumping syndrome – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/dumping-syndrome/

  This factsheet is about dumping syndrome. The diagnosis of dumping syndrome is based on the development of symptoms in a patient with a history of stomach surgery although tests may be needed to exclude other conditions that have similar symptoms. These tests may include blood tests, endoscopy, ultrasound (to rule out gallstones) and/or gastric emptying studies. The latter is carried out by consuming a meal which has been tagged with a small amount of radiation and measuring the rate at which it empties from the stomach. If symptoms of hypoglycaemia (low blood sugar) are present, this may be confirmed by a glucose tolerance test (when a glucose drink is given and blood sugar tests collected over a few hours). […] Once the condition has been diagnosed, a referral to a dietitian should be made. They will explain the general dietary changes required and tailor them to your needs. They may suggest you keep a food and symptom diary to check whether the dietary changes are having a beneficial effect. It is important that weight is monitored after making the necessary dietary modifications to ensure that sufficient calories are being eaten. If significant weight loss is experienced, this must be mentioned to the dietitian or doctor. If symptoms do not improve after dietary modification, ask to see your doctor again so that medication can be considered. […] Post-operative dumping tends to improve with time and management involves dietary modification, with medications being reserved for severe cases or cases which do not respond to dietary changes.

• #45 What Is Dumping Syndrome?

  https://www.uspharmacist.com/article/what-is-dumping-syndrome

  A suggestive pattern of symptoms in a patient who has undergone gastric surgery should raise the possibility of DS. The diagnosis is made primarily on clinical grounds. Monitored glucose challenge, upper GI series, and gastric-emptying studies have been used to support a DS diagnosis. […] Treating for DS includes changes in how and what patients eat, medications, and, in some cases, surgery. In many cases people have mild DS, and symptoms improve over time with simple changes in eating habits and diet; see TABLE 1. If changing eating habits and diet does not improve symptoms, patients may be prescribed medications, most commonly octreotide or acarbose.

• #46 Pathophysiology, diagnosis and management of postoperative dumping syndrome | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/nrgastro.2009.148

  Dumping syndrome is a frequent complication of esophageal, gastric or bariatric surgery. […] Besides the assessment of clinical alertness and endoscopic or radiological imaging, a modified oral glucose tolerance test might help to establish a diagnosis. […] Diagnosis is based on a suggestive symptom pattern in patients with the appropriate surgical history; a modified oral glucose tolerance test might help to establish the diagnosis. […] In patients who have not responded to initial therapy, (slow-release) somatostatin analogs are the treatment of choice. […] In patients with treatment-refractory dumping syndrome, surgical reinterventions or continuous enteral feeding can be considered, but the outcomes of such approaches are variable.

• #47 International consensus on the diagnosis and management of dumping syndrome | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-0357-5

  In patients with suspected dumping syndrome, the diagnosis can be established using symptom-based questionnaires, by oral glucose challenge testing and other diagnostic investigations. […] The modified oral glucose tolerance test is the preferred diagnostic method to confirm the diagnosis of dumping syndrome, and diagnostic parameters for early dumping syndrome are well established: an increase in haematocrit 3% at 30min or an increase in pulse rate 10bpm after 30min. […] The test is considered positive if late (120-180min) hypoglycaemia occurs, or if an early (30min) increase in haematocrit level of more than 3% occurs. […] The current consensus selected 50mg/dl as a cut-off value for defining late hypoglycaemia in dumping syndrome.

• #48 Pathophysiology, Diagnosis and Management of Postoperative Dumping Syndrome

  https://www.medscape.org/viewarticle/707838_3

  A suggestive symptom pattern in a patient who has undergone upper abdominal surgery should give cause to investigate the possibility of dumping syndrome. […] In 1970, Sigstad proposed a scoring system, based on the occurrence of different symptoms of dumping syndrome, to calculate a diagnostic index. […] The presence of hypoglycemia concurrently with several other symptoms is a strong indicator of dumping syndrome (although the occurrence of insulinoma needs to be excluded). […] A provocative test for assessing dumping syndrome can be used to confirm clinical suspicion. […] The provocative test is considered positive if late (120-180 min) hypoglycemia occurs, or if an early (30 min) increase in hematocrit of more than 3% occurs. […] The best predictor of dumping syndrome seems to be a rise in the pulse rate of more than 10 bpm after 30 min.

• #49 Dumping syndrome – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/dumping-syndrome/

  This factsheet is about dumping syndrome. The diagnosis of dumping syndrome is based on the development of symptoms in a patient with a history of stomach surgery although tests may be needed to exclude other conditions that have similar symptoms. These tests may include blood tests, endoscopy, ultrasound (to rule out gallstones) and/or gastric emptying studies. The latter is carried out by consuming a meal which has been tagged with a small amount of radiation and measuring the rate at which it empties from the stomach. If symptoms of hypoglycaemia (low blood sugar) are present, this may be confirmed by a glucose tolerance test (when a glucose drink is given and blood sugar tests collected over a few hours). […] Once the condition has been diagnosed, a referral to a dietitian should be made. They will explain the general dietary changes required and tailor them to your needs. They may suggest you keep a food and symptom diary to check whether the dietary changes are having a beneficial effect. It is important that weight is monitored after making the necessary dietary modifications to ensure that sufficient calories are being eaten. If significant weight loss is experienced, this must be mentioned to the dietitian or doctor. If symptoms do not improve after dietary modification, ask to see your doctor again so that medication can be considered. […] Post-operative dumping tends to improve with time and management involves dietary modification, with medications being reserved for severe cases or cases which do not respond to dietary changes.

• #50 Dumping Syndrome | Stomach Cancer | Cancer Council NSW

  https://www.cancercouncil.com.au/stomach-cancer/managing-side-effects/dumping-syndrome/

  If surgery has changed the structure of your stomach, partially digested food can go into the small bowel too quickly. This combination of symptoms is called dumping syndrome. Symptoms usually begin 15–30 minutes after eating. […] Sometimes symptoms occur 1–2 hours after a meal. These are called late symptoms, which tend to cause weakness, light-headedness and sweating, and are usually worse after eating foods high in sugar. […] Symptoms usually improve over time. If they don’t, ask or advice about medicines that may help.

• #51 Dumping Syndrome: Updated Perspectives on Etiologies and Diagnosis – Practical Gastro

  https://practicalgastro.com/2014/10/18/dumping-syndrome-updated-perspectives-on-etiologies-and-diagnosis/

  Dumping syndrome (DS) has historically been associated with gastric surgery and vagotomy, as well as diabetes mellitus (DM). This article provides an update on the etiologies and clinical spectrum that represent the current DS patient population. […] The diagnosis of late dumping syndrome is made by the clinical presentation of late dumping symptoms and can be confirmed by an oral glucose test demonstrating low glucose levels sometimes less than 60 mg/dL at 2 or 3 hours. […] Our report highlights a patient population with a strong representation of non-surgical etiologies of DS. […] It is important to note here that our medical center does not specialize in a common cause of DS in the current era, namely bariatric surgery. […] Our expectation is that increased awareness will contribute to appropriate management and referrals for these patients, and treatments with anti-motility instead of promotility agents.

• #52

  https://link.springer.com/article/10.1007/s10620-009-0939-5

  To investigate the current incidence and identify the current etiologies of rapid gastric emptying (dumping syndrome) in patients with a spectrum of gastrointestinal symptoms, including nausea, vomiting, abdominal pain, or diarrhea. […] The results for a 4-h radionuclide gastric emptying test (GET) using a standardized scintigraphic technique were reviewed in 545 patients to see which patients met criteria for rapid gastric emptying, defined as 50% emptying of isotope-labeled solid meal at 1 h. […] Rapid gastric emptying can be identified in a sizeable subset (9%) of patients with unexplained nausea, vomiting, abdominal pain, and diarrhea when criteria are applied to the standardized scintigraphic gastric emptying meal.

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