Dumping syndrome is infrequently reported in children, but has significant morbidity. It may be difficult both to diagnose and manage. Two children are reported who developed dumping syndrome after Nissen fundoplication. Symptoms occurred soon after the operation and included post-prandial pallor, sweating, lethargy and diarrhoea.
Is late dumping syndrome an underdiagnosed complication of laparoscopic Nissen fundoplication?
This is the first reported case of late dumping syndrome in an adult following laparoscopic Nissen fundoplication. The apparently high incidence of this in the pediatric literature might suggest that it is an underdiagnosed complication in adults.
What are the possible complications of Nissen fundoplication in adults?
It is a rare complication of Nissen fundoplication in adults. We report the case of a patient with oesophageal compressive symptoms (dysphagia, oesophageal food impaction and regurgitation) and frequent episodes of sweating and hypoglycaemia after a Nissen fundoplication to treat gastroesophageal reflux disease.
What is dumping syndrome in the stomach?
Background. Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults.
What is the pathophysiology of acid dumping syndrome?
Dumping syndrome (DS) is a debilitating entity with gastrointestinal and vasomotor symptoms due to rapid gastric emptying. It is a rare complication of Nissen fundoplication in adults.
What are the symptoms of dumping syndrome?
Dumping syndrome is a group of symptoms, such as diarrhea, nausea, and feeling light-headed or tired after a meal, that are caused by rapid gastric emptying. Rapid gastric emptying is a condition in which food moves too quickly from your stomach to your duodenum.
How long does dumping syndrome last?
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.
Which describe the first stage of dumping syndrome?
Dumping Syndrome: Symptoms of the Early Phase A feeling of fullness, even after eating just a small amount. Abdominal cramping or pain. Nausea or vomiting. Severe diarrhea.
Is it normal to have diarrhea after Nissen fundoplication?
Some patients also find that they have diarrhea or "loose bowels" for the first days after their hernia repair — in the vast majority of cases, the bowel function normalizes with time. Constipation may also be common due to the pain medication.
How do you get rid of dumping syndrome fast?
Doctors may prescribe acarbose (Prandase, Precose) link to help reduce the symptoms of late dumping syndrome. Side effects of acarbose may include bloating, diarrhea, and flatulence. If changing your eating habits doesn't improve your symptoms, your doctor may prescribe medicines.
What triggers dumping syndrome?
When food moves too quickly from your stomach to your duodenum, your digestive tract releases more hormones than normal. Fluid also moves from your blood stream into your small intestine. Experts think that the excess hormones and movement of fluid into your small intestine cause the symptoms of early dumping syndrome.
What foods should you avoid with dumping syndrome?
Avoid simple sugars such as sweets, candy, soda, cakes, and cookies. Avoid foods that are very hot or very cold. These can trigger dumping syndrome symptoms. Do not drink liquids with your meal.
What foods help dumping syndrome?
Basic Guidelines to Avoid Dumping Syndrome Eat more slowly and chew your food thoroughly. Eat a source of protein at each meal. Poultry, red meat, fish, eggs, tofu, nuts, milk, yogurt, cheese, and peanut butter are good choices.
How is dumping syndrome diagnosed?
By tracking the radioactive material, a health care professional can measure how fast your stomach empties after the meal. The health care professional will scan your abdomen several times to see how fast your stomach empties for up to 4 hours after the meal. The test can help confirm a diagnosis of dumping syndrome.
How do you prevent dumping syndrome?
Generally, you can help prevent dumping syndrome by changing your diet after surgery. Changes might include eating smaller meals and limiting high-sugar foods. In more-serious cases of dumping syndrome, you may need medications or surgery.
What causes rapid bowel movement after eating?
The gastrocolic reflex is a normal reaction the body has to eating food in varying intensities. When food hits your stomach, your body releases certain hormones. These hormones tell your colon to contract to move food through your colon and out of your body. This makes room for more food.
Can vomiting undo a Nissen fundoplication?
Just as other body parts, the fundoplication wrap created during the GERD surgery will slowly loosen over time. Therefore even some patients that originally could not burp or vomit will be able to do so as the wrap loosens.
SUBJECTS AND METHODS
From 1989 to 1993, Nissen fundoplication was performed in 50 consecutive infants and children (29 boys and 21 girls) with severe gastroesophageal reflux. The mean age at the time of operation was 40 months (range, 2 months to 15 years); 22 patients (44%) were below the age of 1 year.
RESULTS
In the immediate postoperative course, five patients had severe intolerance to oral feeding, postprandial irritability, diarrhea, diaphoresis, and lethargy. In these patients, postprandial glucose levels were in the range of 310-240 mg/dl (mean, 260; SD ± 61).
DISCUSSION
Dumping syndrome is a well-recognized complication of gastric surgery in adults, but it is considered to be rare in children. Insufficient attention has been paid to this specific complication of Nissen fundoplication in children (8,9).
REFERENCES
1. Villet R, Brereau M, Hayat P, Weisgerber G. Une complication grave de l' operation de Nissen; le dumping syndrome. Apropos de 4 observations. Chir Pediatr 1978;19:269-73.
