Alerts and Notices
SynopsisDumping syndrome is characterized by the rapid transit of ingested food contents into the small intestine, often occurring in patients after esophageal, bariatric, or gastric surgery. Viral illnesses and diabetes mellitus can also cause dumping syndrome. Most patients have early symptoms within one hour of eating characterized by early satiety, abdominal pain or bloating, diarrhea, and nausea. Some patients will also experience flushing, presyncope, or palpitations. Late dumping syndrome, also known as postprandial hyperinsulinemic hypoglycemia, is a rare complication of bariatric surgery. It typically develops months to years after surgery. Symptoms occur 1-3 hours after eating carbohydrates, and the condition is characterized by presyncope and diaphoresis. This is attributed to hypoglycemia.
Dumping syndrome can result in severe protein or calorie malnutrition and specific nutritional deficiencies. In the acute setting, patients can present with sequelae of dehydration including hypotension, hypovolemic shock, and end-organ injury (ie, acute kidney injury).
Nutritional counseling and dietary changes are the hallmarks of management.
K91.1 – Postgastric surgery syndromes
235666009 – Early dumping syndrome
235667000 – Late dumping syndrome
Differential Diagnosis & Pitfalls
- Diabetes mellitus with hypoglycemic episodes
- Menetrier disease
- Carcinoid syndrome
- Chronic pancreatitis
- Celiac disease
- Small or large bowel obstruction
- Bile acid diarrhea
- Inflammatory bowel disease (eg, Crohn disease, ulcerative colitis)
- Irritable bowel syndrome
- Microscopic colitis
- Lactose intolerance
- Protein-losing enteropathy