Dumping syndrome

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Diagnosis

If you have a history of gastric surgery, even if it was years ago, your healthcare provider may be able to diagnose dumping syndrome based on your symptoms alone. They may give you a self-assessment questionnaire called the Dumping Symptom Rating Scale that scores your symptoms to determine how severe they are. They may also want to run tests to confirm the diagnosis or to rule out other possible causes of your symptoms. This is especially important if you don’t have a history of gastric surgery.


Tests to diagnose dumping syndrome include:


Oral glucose tolerance test. This test measures your blood sugar before and after you drink a glucose solution. It also measures your hematocrit (red blood cell count). A rise in hematocrit after you drink the glucose indicates large volumes of fluids moving from your bloodstream into your intestines. A drop in blood sugar one to three hours afterward indicates late 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 wasn’t well-absorbed in your small intestine. This suggests that your small intestine was too overloaded.

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). After you drink the solution, a technician takes a series of video X-rays (called fluoroscopy). The series will show how fast the solution travels.

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.


Treatment

Early dumping syndrome is likely to resolve on its own within three months. In the meantime, there's a good chance that dietary changes will ease your symptoms. If not, your health care provider may recommend medications or surgery.


Medications

If changes to your diet don't improve symptoms, your health care provider may prescribe octreotide (Sandostatin). This anti-diarrheal drug, administered by injection under your skin, can slow the emptying of food into the intestine. Possible side effects include nausea, diarrhea and fatty stools (steatorrhea).


Talk with your doctor about the proper way to self-administer the drug.


Surgery

If conservative approaches don't help, surgery may be recommended. Depending on your situation, surgical procedures to treat dumping syndrome may include reconstructing the pylorus or surgery to reverse gastric bypass surgery.