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At least 127 records · Page 7Linked to original sources
PubMed1990

Octreotide in the treatment of the dumping syndrome.

The effects of octreotide were investigated in 10 patients with dumping syndrome consequent on gastric surgery. A subcutaneous injection of 50 or 100 micrograms octreotide had a significant beneficial effect on certain objective measurements of dumping: packed cell volume, pulse, and blood pressure in patients with early dumping and blood glucose in those with late dumping. Symptoms were also remarkably reduced, as judged subjectively. Long-term self-administered octreotide, initially 50 micrograms b.i.d. and rising to 100 micrograms t.i.d. as necessary, in 5 patients caused improvement in symptoms in 2. In summary, octreotide has an objective effect on dumping and clinical studies suggest a role for octreotide in patients with severe symptoms.

Adult↗
PubMed1977

[Surgical treatment of the Dumping-syndrome (author's transl)].

We observed 106 patients suffering from severe dumping syndrome after gastric resection. For remedying the authors performed Billroth-I reconstruction, the Sacharov-Henley operation, antiperistaltic interposition of a short jejunal segment and practiced a new method of their own: interposition of a long iliac segment. The results obtained are reported.

Adult↗
PubMed1975

[Results of reconstructive jejunogastroplasty in dumping syndrome].

135 reduodenizations were performed for grave forms of the dumping-syndrome. Clinico-roentgenological investigations of patients in later terms after reduodenization have evidenced the development of great morphological and functional compensatory changes of the gastric stump, jejunal graft, duodenum and other portions of the small intestine. The results of reconstructive surgery in different terms of observations are presented.

Dumping Syndrome↗
PubMedDate not supplied

Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up.

Dumping syndrome is a sequel of gastric surgery in adults and Nissen fundoplication in children. The syndrome is characterized by various gastrointestinal symptoms as well as irritability, diaphoresis and lethargy. Shortly after a meal, symptoms are associated with hyperglycemia (early dumping), followed by late dumping symptoms associated with reactive hypoglycemia. Several therapeutic and dietary manipulations failed to control these symptoms in previous reports as well as in an infant we have followed after Nissen fundoplication. Acarbose, an alpha-glucosidase inhibitor, has been used sporadically in adults after gastric surgery, but only once in children. In most of these studies, the effect of acarbose (on reactive hypoglycemia) was evaluated over several hours postprandially or after oral glucose load. In our study, we recorded glucose dynamics by a continuous glucose monitor system over 2 to 3 days before and during acarbose treatment, while the patient was on a well-controlled diet. These measurements (720 before and 832 on therapy) suggested that both early and late dumping symptoms are causally related to the rate of glucose elevation and decline, rather than to glucose peak and nadir, respectively. Acarbose attenuated both postprandial glucose hyperglycemia and reactive hypoglycemia, which subsequently led to a significant reduction in dumping symptoms. In a follow-up of 14 months, acarbose was well tolerated and the frequency of dumping symptoms was remarkably reduced.

Acarbose↗
PubMed2004

[Ultrasonic examination of gastric stump and gastroenteroanastomosis in complex diagnosis of postresection dumping syndrome].

Long-term results of laparoscopic resections of the stomach were studied, a comparative analysis with similar open surgeries was carried out. The comparative analysis was based on the results of ultrasonic examination (USE) of the gastric stump (GS) and gastroenteroanastomosis (GEA). Basing on ultrasonic parameters of GS, digital parameters of GEA in mild, moderate and severe degree of dumping-syndrome were determined. Ultrasonic examinations of the gastric stump permitted to study its function in dumping-syndrome of different degree, to reveal sizes of GEA in relaxation and contraction stage, and based on these data to determine its gradients of contractility. Ultrasonic method in long-term period after resection of the stomach has advantages compared with gastroscopic and X-ray methods.

Anastomosis, Surgical↗
PubMed2001

Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose.

Reactive hypoglycaemia is a rare disease which occurs postprandially in everyday life involving blood glucose levels below 2.5 to 2.8 mmol/l. We report on a 66-year-old patient who developed symptomatic reactive hypoglycaemia due to late dumping syndrome 10 years after oesophagectomy with cervical anastomosis. A 75 g sucrose load revealed a plasma glucose level of 9.4 mmol/l after one hour, followed by symptomatic hypoglycaemia with a plasma glucose level of 1.8 mmol/l after three hours. Concomitantly, high concentrations of insulin (3216 pmol/l at a glucose level of 9.4 mmol/l and 335 pmol/l at a glucose level of 1.8 mmol/l) and glucagon-like peptide 1 (GLP-1) (375 pmol/l at a glucose level of 9.4 mmol/l and 85 pmol/l at a glucose level of 1.8 mmol/l) were measured. While the patient was under treatment with acarbose, another sucrose load did not provoke symptomatic hypoglycaemia (plasma glucose nadir of 4.6 mmol/l after two hours). Insulin and GLP-1 levels increased much less, to peak levels of 375 pmol/l and 75 pmol/l respectively, after one hour when plasma glucose was 6.8 mmol/l. We conclude that in patients with reactive hypoglycaemia due to gastrointestinal surgery, acarbose decreases rapid glucose absorption associated with hyperglycaemia and GLP-1 secretion, and thus diminishes excessive insulin release. Acarbose is therefore a successful treatment modality for reactive hypoglycaemia due to late dumping syndrome.

Acarbose↗
PubMed1992

[The release of vasoactive intestinal peptide in patients with dumping syndrome and its clinical significance].

Plasma vasoactive intestinal peptide (VIP), blood glucose concentration and hematocrit (HCT) were measured in 15 patients after Billroth-II subtotal gastrectomy (B-II SG) and 8 healthy controls before and after oral glucose ingestion. In B-II SG group the rate of rise of VIP concentration was in positive correlation to the rate of rise of HCT (r = 0.501 P < 0.05) and to that of blood glucose (r = 0.715 P < 0.01). Also, the elevation rate of HCT blood glucose and VIP concentration was significant higher in B-II SG group than in controls (P < 0.05). It was found that the elevation rate of VIP concentration was much higher in patients with dumping syndrome after B-II SG than those without (P < 0.05). The results suggest that VIP may play a role in the pathogenesis of dumping syndrome.

Blood Glucose↗
PubMed1990

[Prevention of dumping syndrome after distal gastrectomy in peptic ulcer].

Operations were performed on 386 patients with peptic ulcer by a method suggested by the authors for gastric resection with formation of a sphincter in the region of the anastomosis. In 18 patients a Billroth II anastomosis was reconstructed into a Billroth I anastomosis by the authors' modification in severe dumping syndrome. Complex examination was conducted in late-term postoperative periods in 324 patients after primary resection and in 18 after reconstructive operation. A mild dumping syndrome was found in 9 (2.8%) and 3 patients, respectively. The results of the study show that if the authors' requirements regarding the volume and method of gastric resection are abided by, there is no doubt that the suggested method has advantages over the classical method in that the reservoir function of the stomach is maintained, hydrochloric acid secretion reduces to a state of hypo- or normoacidity, and the peristaltic component of evacuation is preserved due to the formed functionally active anastomosis.

Adolescent↗
PubMed1981

Pectin in the dumping syndrome: reduction of symptoms and plasma volume changes.

Twelve patients with the dumping syndrome took on one occasion oral hypertonic glucose and on another a similar glucose drink to which pectin was added. After glucose alone eleven patients had symptoms; after glucose with pectin, six had no symptoms and in five symptoms were reduced. Plasma volume changes were significantly less after glucose with pectin, and the hypoglycaemia at 120 min after glucose alone did not occur after glucose with pectin in patients in whom symptoms were abolished. Gastric emptying was prolonged, and serum insulin levels were lower, after glucose with pectin. In those patients to whom gastric emptying rate reverted to near normal with pectin, symptoms were abolished, but symptoms were only reduced in number when gastric emptying, although slowed, remained rapid. The findings suggest that pectin and similar substances may be useful in the day-to-day management of patients with dumping symptoms.

Adult↗
PubMed2003

[Dumping syndrome in a child with an incorrectly positioned gastrostomy catheter].

A 13-month-old girl experienced an epileptic fit due to hypoglycaemia. She was born with a posterolateral diaphragm defect and at the age of 1.5 months had undergone a Nissen fundoplication with which a gastrostomy was also performed. The tip of the gastrostomy catheter was found to be lying in the bulbus duodeni. Once this had been pulled back, the patient made a good recovery. Dumping syndrome is usually the result of a quicker gastric emptying time or a smaller gastric capacity, and in children it is mostly due to a Nissen fundoplication. In patients fed by tube who exhibit symptoms of dumping syndrome, the position of the feeding tube must be checked before other diagnostic or therapeutic steps are undertaken.

Dumping Syndrome↗
PubMed1991

Nutritional manipulation in the management of dumping syndrome.

Two children with Nissen's fundoplication and either gastrocystoplasty or pyloroplasty developed dumping syndrome. Correction of their blood glucose abnormalities, resolution of symptoms, and weight gain were effectively achieved by addition of fats and uncooked corn starch (50 g/l) to their feeds.

Blood Glucose↗
PubMed1999

Long-term results of octreotide-therapy in severe dumping syndrome.

OBJECTIVE: Little is known about the long-term results of octreotide therapy in dumping syndrome. We report the results of an open study including 20 patients with severe dumping symptoms after gastric surgery treated with octreotide between 1987 and 1997 at the Leiden University Medical Centre. DESIGN: Patient selection was based on (1) the results of a dumping provocation test and (2) symptoms that were refractory to other therapeutic measures. At regular intervals the presence of dumping symptoms was evaluated together with measurement of body weight and faecal fat excretion. RESULTS: Mean follow-up was 37 +/- 9 months (range 1-107 months). Doses of octreotide ranged from 25 to 200 microg/day. Initial relief of symptoms was achieved in all subjects, but after three months of therapy symptom relief persisted in 80% of patients. Mean body weight increased by 2.4 +/- 1.2 kg despite a significant increase in faecal fat excretion from 10 +/- 2 g/24 h to 24 +/- 3 g/24 h. Reasons for discontinuation of therapy were diminished efficacy in the longer term in 4 patients and side-effects in 7 patients. Biliary complications were encountered in 3 patients. CONCLUSIONS: Self-administration of octreotide proves an effective symptomatic treatment of severe dumping, even on the long-term. Its use is frequently limited by the occurrence of side-effects.

Adult↗
PubMed1975

[Transformation surgery in dumping syndrome after Billroth II stomach resection].

After ineffective conservative therapy of the dumping-syndrome the transformation of Billroth's second operation into Billroth's first operation or the interposition of a jejunum segment between reamins of the stomach and duodenum are indicated. The increased risk of operation demands a careful selection of the patients. By means of these interventions an essential improvement of the complaints may be achieved.

Adult↗
PubMed2003

[Anastomotic false-diverticulum causing an atypical dumping syndrome. A case report].

Aim of the study is to evaluate the causes of dumping syndromes following partial gastrectomies, and to report an unusual feature of dumping. A case of early dumping due to diverticular-like dilation of gastro-jejunal anastomosis is described with preoperative imaging and intraoperative picture. The surgical correction led to complete clinical remission; the common causes and physiopathological bases of dumping are reviewed and the role of en-Y gastro-jejunal reconstruction is underlined in order to reduce the risk of developing the syndrome.

Anastomosis, Roux-en-Y↗