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At least 19 recordsLinked to original sources
PubMed1977

[Pathogenesis, diagnosis and therapy of the dumping syndrome].

The dumping-syndrome is a severe complication of gastric surgery after operations which destroy or weaken the sphincter mechanism of the pylorus. The pathogenesis involves the release of kinins, the triggering of neurogen reflex mechanisms by distending the jejunum, the massive flow of fluid in jejunal lumen, the loss of the reservoir function of the stomach, and, possibly, the pathologic release of gastrointestinal hormones. Preoperatively, intensive diagnostic efforts are necessary, which must include a psychiatric check-up. For surgical treatment several modifications of reversal operations from Billroth II to Billroth I with reconstruction of duodenal passage have been developed. Our own modification includes, beside testitution of the duodenal passage, the construction of a gastric pouch.

Dumping Syndrome↗
PubMed1976

The early postprandial dumping syndrome: prevention and treatment.

The early postprandial dumping syndrome can be prevented or minimized by the appropriate selection of the operative procedure to fit the patient and the peptic ulcer problem he presents, and by proper attention to diet in the early postoperative period. When it does occur, the syndrome usually responds favorably to dietary management and tends to spontaneously regress in severity with time. For these reasons further surgery is seldom required for the early postprandial dumping syndrome. In the patient who fails to improve with diet therapy and time and has disabling symptoms often accompanied by progressive malnutrition, revisional surgery should be undertaken. It is the objective of the surgeon to alter the reconstruction in such a way that emptying from the stomach or gastric remnant is delayed. Therefore, the upper small intestine dose not receive a large, rapidly introduced hyperosmolar bolus to initiate the release of humoral substances causing the syndrome. All revisions utilized are potentially ulcerogenic and if vagotomy has not been a part of the original procedure, it should routinely be performed at the time of revision. Patients who have primarily has a Billroth II gastrectomy will frequently improve markedly with simple conversion to a Billroth I reconstruction. This is particularly true when the residual stomach is moderately large (i.e., after antrectomy) and when the gastrojejunal stoma is larger in diameter than the normal jejunum. Under such circumstances approximately 80 per cent of patients will improve sufficiently so that a more complex procedure need not be utilized at once. Under all other conditions we prefer a 10 cm. segment of reversed jejunum anastomosed proximally to the gastric stump and distally to a 40 cm. isoperistaltic Roux-en-Y jejunal limb. This procedure is so successful that one can justify its use as first recourse even in the anatomically favorable Billroth II patient. It should be pointed out emphatically that an isoperistaltic jejunal interposition (Henley loop) has little or no effect on the early postprandial dumping syndrome and should not be considered. Plicated loops of intestine to recreate a gastric reservoir frequently fail to empty satisfactorily and the incidence of satisfactory results is too low to consider their utilization in surgical treatment of the dumping syndrome.

Adult↗
PubMed1990

[The effect of somatostatin in dumping syndrome].

The effect of cyclic somatostatin on early and late dumping syndrome was studied in 12 patients with gastric resection. Each patient underwent two glucose challenges with 75 grams of glucose administered orally. In the control study isotonic sodium chloride was given, while in the other study cyclic somatostatin in a dose of 250 micrograms bolus injection followed by infusion of 80 ng/kg/min for a period of 270 minutes. In the control study all patients showed subjective symptoms of the early dumping syndrome with significant increases in pulse rate, hematocrit, and vasoactive intestinal polypeptide. Ten patients showed asymptomatic hypoglycemia, as a sign of the late dumping syndrome associated with a significant increases of insulin, gastric inhibitory peptide and glucagon levels. During the administration of somatostatin these changes failed to develop. These results indicate that somatostatin alleviates the symptoms of early and late postprandial dumping syndrome.

Dumping Syndrome↗
PubMedDate not supplied

[Effects of wheat bran on the rate of gastric stump and small intestine evacuation in patients with dumping syndrome after stomach resection].

A total of 65 patients with dumping syndrome after gastric resection were under study. It has been found that addition of 10 and 20 g of wheat bran to semolina porridge significantly (p less than 0.05) inhibits the rate of gastric stump and small intestine evacuation, and in 1/3 of the patients it promotes lowered manifestation and duration of dumping syndrome. It has been suggested that the inhibitory action of wheat bran is caused by bran viscosity and, probably, mediated by intestinal hormones released from endocrine cells of the small intestine mucosa. The results of the investigations conducted can be used in the validation of the diet therapy of patients with dumping syndrome.

Diet↗
PubMed1975

Proximal jejunal reversal procedure without interposition for management of dumping syndrome.

For control of disabling dumping syndrome, a short jejunal reversal interposition between the gastric remnant and the duodenum or between the gastric remnant and the jejunum with or without a second jejunal reversal is in current use. A new procedure, proximal jejunal reversal based on a modified antiperistaltic Roux-en-Y without interposition of the jejunal loop is presented and three cases are reported.

Adult↗
PubMed1977

Dumping syndrome and diarrhoea after vagotomy.

The frequency and severity of the post-vagotomic dumping syndrome and diarrhoea were studied in 470 cases. After vagotomy the incidence of the dumping syndrome is lower and that of diarrhoea higher than after conventional gastric resection. The dumping syndrome occurred in 8.30 percent [39 cases], but only three patients belonged into the severe group [0.80 percent]. The frequency of post-vagotomy diarrhoea was 11.49 percent [54 cases] of which six belonged into the severe group [1.34 and 1.04 percent, respectively]. The possibility respectively of preventing or reducing the frequency of these side-effects is discussed.

Diarrhea↗
PubMed1975

[Work capacity of patients with dumping syndrome after stomach surgery].

Of 528 patients subjected to radical operations on the stomach for cancer, polyposis and ulcerous disease the dumping-syndrome was revealed in 74 patients. Following resection of the distal gastric portion the latter was observed in 49 cases, after resection of the cardia--in 18, and after gastrectomy--in 7. In most patients with the dumping-syndrome an impairment of basic hepatic functions and motor-evacuative function of the gastric stump was observed. The study of the work capacity in patients with the dumping-syndrome has deomonstrated its reduction in most patients (in 74% of cases). 55 of 74 investigated patients proved to be invalids of the second and third group. The capacity for work was mostly impaired in patients showing the dumping-syndrome of average and severe gravity.

Adult↗
PubMed1990

[Atrial natriuretic peptide in dumping syndrome].

The significance of atrial natriuretic factor (ANF) was investigated in the maintenance of the fluid volume in hypovolemia associated with dumping syndrome following gastric resection. The study was performed on 10 patients with Billroth II procedure. Ten age and sex matched patients--without previous gastric surgery served as controls. Each patient underwent oral glucose challenge. The patients following gastric resection underwent an other glucose challenge with intravenous infusion for the maintenance of the fluid volume. All patients with gastric resection showed subjective symptoms of the early dumping syndrome with significant (p less than 0.001) increases in heart rate and in hematocrit, while plasma ANF level decreased significantly (p less than 0.01). Significant negative correlation was found between the changes in hematocrit and the changes in plasma ANF level (r = -0.89; p less than 0.001). Neither the subjective symptoms characteristic for early dumping syndrome, nor changes in the laboratory parameters were noted in the patients during the challenge with infusion. The results show that the hypovolemia in dumping syndrome is associated with significant decreased ANF activity, and in the regulation of ANF release besides the well known stimulating effect of hypervolemia, there exists an inhibition of secretion in volume depleted states.

Atrial Natriuretic Factor↗
PubMed1991

Dumping syndrome after combined pyloroplasty and fundoplication.

Dumping syndrome in infancy is a rare complication following gastric surgery. We describe an 11-month-old infant affected by recurrent peptic oesophagitis who underwent a combined Nissen fundoplication and pyloroplasty. Early dumping symptoms such as irritability, pallor, sweating, abdominal distension and watery diarrhoea were observed postoperatively after bolus feeding. Gastric emptying, measured after the administration of 150 ml of regular cow milk mixed with 200 microCi (8 MBq) of technetium-99m sulfur colloid (99mTc-SC), demonstrated an early rapid and massive emptying of the isotopes into the small intestine, followed by duodenogastric reflux and a second wave of emptying and reflux at 9 min. The initial pattern of gastric emptying and duodenogastric reflux was followed by a slow emptying phase with half-emptying time of 81 min. Isotope studies should be used to investigate motility disorders caused by this type of anti-reflux operation.

Dumping Syndrome↗
PubMedDate not supplied

[The morphofunctional state of the gastric stump in patients with the dumping syndrome and its significance for the formulation of diet therapy].

In 42 patients with the dumping syndrome. the mucosa of the resected gastric stump was examined histologically. Bioptic materials were obtained by applying fibrobiopsy and aspiration biopsy under roentgenological control. The great majority of the examined demonstrated some or other degree of the glandular atrophy attended by a fall of the secretary function. In spite of a considerable time lapsed since gastric resection the gastric glands remained intact and the secretary function of the stump continued to be normal. According to the authors the severity of the dumping syndrome does not depend on the nature of morphological changes in the gastric stump mucosa. A sizable proportion of the examined patients demonstrated various changes in the motor function of the stump, more often an accelerated evacuation. The listed changes in the morphological-functional condition of the gastric stump were given due consideration in compiling a dietary pattern for patients with the dumping syndrome.

Dumping Syndrome↗
PubMed1976

Gastric antrum and dumping syndrome. Possible pathogenetic correlations.

On the basis of the observation that the dumping syndrome is seen very rarely now compared to the past, experimental and clinical research was carried out with a view to explaining this phenomenon. These studies showed that it is possible that the gastric antrum plays a basic role in the pathogenesis of the dumping syndrome.

Dumping Syndrome↗
PubMed1990

[Gastric motility and post-gastrectomy dumping syndrome].

A direct relationship was revealed between disorders of gastric motility before the operation and the frequency and severity of the post-gastrectomy dumping syndrome in patients with peptic ulcer. The level of increase in the frequency and amplitude of the contractions and the basal tonus of the gastric stump may serve as an objective criterion for establishing the severity of the dumping syndrome. Patients with an initial hyperkinetic type of motility are predisposed to the dumping syndrome, which must be borne in mind in choosing a variant of the operation and the method for creating the gastrointestinal anastomosis.

Dumping Syndrome↗
PubMed1977

[Serotonin and the dumping syndrome (author's transl)].

The serotonin level in patients after a 2/3 resection of the stomach (Billroth II) is normal to moderately raised. Patients with a dumping syndrome show no significantly different figures for the excretion of free serotonin in the 24-hr urine. The level of serotonin in patients after gastric operation is regulated to normal or slightly raised values by increased serotonin production in the gastrointestinal tract whether a dumping syndrome develops or not. Knowledge of the serotonin levels is consequently of therapeutic significance because a dumping syndrome may exist with and without raised serotonin values.

Dumping Syndrome↗
PubMed1990

[The effect of calcium antagonists on the rate of gastric emptying in patients with duodenal peptic ulcer and the dumping syndrome].

Comparative evaluation of single-dose finoptin, corinfar and falicor by effect on gastric evacuation was conducted in 33 peptic ulcer and 48 postgastrectomy dumping syndrome patients. Finoptin was found to prolong the evacuation in contrast to corinfar which stimulated it. Nonsignificant delay in gastric evacuation occurred in falicor administration. When designing therapy of cardiovascular diseases associated with gastric evacuation, due consideration should be given to pharmacokinetic action of calcium antagonists and functional status of gastric evacuation. Finoptin is preferable in dumping syndrome, corinfar in slow gastric evacuation. In view of the above corinfar treatment is undesirable in postgastrectomy patients, otherwise they could develop rapid gastric stump evacuation and dumping syndrome.

Adult↗
PubMed1975

Gastroenteric anastomosis in Billroth II gastrectomy with maintenance of the physiologic diameter of the normal pylorus to prevent the dumping syndrome. Part II. Results in 1,300 cases.

Clinical results of the use of a gastroenteric anastomosis with a diameter the size of the normal pylorus (1.9 cm) in 1,300 cases between 1954 and 1971 are presented mainly in terms of prevention of the dumping syndrome. We have had no patient with clinical manifestations of any degree of the dumping syndrome in the first two years after operation. These excellent results have led us to employ the method routinely. We recommend this method for its simplicity and, above all, its effectiveness in preventing the dumping syndrome.

Dumping Syndrome↗
PubMed1976

The early postprandial dumping syndrome: clinical manifestations and pathogenesis.

Our present concept of the pathogenesis of the early postprandial dumping syndrome is well summarized by Jesseph. Resection, division or bypass of the sphincter mechanism at the gastric outlet permits rapid passage of hyperosmolar material into the upper small intestine. This provides direct stimulation of the enterochromaffin (argentaffin) cells in the mucosa, which are highly concentrated here. The hyperosmolarity pulls fluid into the intestine resulting in a fall in plasma volume and distention of the intestine, further stimulating secretion by the argentaffin tissue. The plasma volume per se probably has little, if anything, to do with the symptoms produced although the outpouring of intravascular fluid into the intestinal lumen probably contributes to intestinal hyperperistalsis and the resultant symptoms of intestinal hurry. Although other sources are possible, studies to date would indicate that the argentaffin cells are the major source of humoral agents. In addition to serotonin, at least one vasoactive polypeptide, bradykinin, has been identified. It is likely that others are present and pharmacologic therapy will probably not be successful until these are more completely identified and characterized. The known biologic effects of serotonin and the kinins can certainly account for all the vasomotor and gastrointestinal symptoms characterizing the early postprandial dumping syndrome.

Adult↗