Gastric Dysmotility Syndromes: Dumping Syndrome

by Carlo Raj, MD

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    00:01 Let's take a look at Dumping syndrome. So if gastroparesis is due to a functional immobility not an obstructive, what's dumping? A complication of surgery during resection of pylorus, which means what? Now, you have highly osmolar substances in which there isn't enough time or there is inadequate time of properly churning your chyme and such in the stomach. So therefore it quickly will dump the content of the stomach into the duodenum.

    00:33 Osmolar food particles into the gut after a meal. Supraphysiologic release of peptide and vasoactive mediators with reactive hypoglycemia are things that you're looking for with Dumping syndrome. Because you're hurriedly dumping everything out. The body gets a little sensitive and it wants to take care of the issues as quickly as possible.

    00:56 So there is going to be not this slow sustained controlled release of insulin. But with all of those being dumped into the duodenum then at this point understand that the triggers such as your GLP−1 and so on and so forth, are going to come in and they're going to excessively release insulin.

    01:15 So all your peptides and vasoactive are all coming out very quickly. Dizziness, flushing, palpitations and diaphoresis shortly after the ingestion of the meal. It's actually quite stressful. Be able to identify your symptoms. Surgery. Complication due to resection of pylorus is one of your major causes.

    01:41 So therefore with Dumping Syndrome, because it's quite difficult, remember, once surgery takes place, it's quite difficult to, to retract the issue and it's quite difficult to come back to complete normalcy.

    01:55 You just keep that in mind in general either on your boards or on your wards or especially those of you that are going into surgery. Once you perform the surgery, everyone behaves a little bit differently.

    02:05 For example, adhesions and so on and so forth. So, everyone behaves a little bit differently.

    02:11 So now with Dumping Syndrome because now you're educating your patient over the long haul, you may not be able to correct the dumping. So therefore you tell the patient instead of having that normal meals that they were having, maybe three times a day or maybe they were just, you know, a stressful job and they were just eating something really quick, your recommendation: small frequent meals with minimal liquid, low carbohydrate diet, drink fluid between the meals only and high protein diet.

    02:45 Now, obviously that has its own set of complications but really you have to manage your patient accordingly.

    About the Lecture

    The lecture Gastric Dysmotility Syndromes: Dumping Syndrome by Carlo Raj, MD is from the course Stomach and Duodenum Diseases.

    Author of lecture Gastric Dysmotility Syndromes: Dumping Syndrome

     Carlo Raj, MD

    Carlo Raj, MD

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