Introduction

Approximately 10%-50% of patients develop some manifestations of the dumping syndrome after gastric surgery. Among them, 5%-10% have clinically significant symptoms, and 1%-2% are debilitated by them.¹ Early dumping, typically starting 10-30 minutes after a meal, usually involves both vasomotor and gastrointestinal complaints such as sweating, palpitation, weakness and faintness, abdominal bloating, cramping, and profound diarrhoea. Late dumping, often occurring 2-3 hours postprandially, involves mainly vascular complaints characterised by perspiration, palpitation, mental confusion, and sometimes syncope. It is estimated that, among all affected patients, 75% have early dumping symptoms. The symptoms of early dumping probably result from rapid emptying of hyperosmolar chyme into the small bowel leading to a large fluid shift from the intravascular space into the intestinal lumen, with consequent rapid small bowel distension and an increase in both the amplitude and frequency of bowel contractions. Late dumping is a consequence of reactive hypoglycaemia resulting from an exaggerated . . . [Full text of this article]