PubMed · 13322835
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A RICHIERI. 1955-12-09. [Dumping syndrome].. https://pubmed.ncbi.nlm.nih.gov/13322835/
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Complete or partial removal of the stomach results in considerable anatomical and physiological changes, which, in turn lead to more or less pronounced dietary problems. For this reason, patients should receive comprehensive postoperative counseling. In the majority of cases, the major problems can be avoided or symptoms ameliorated. The selection of suitable foods must be discussed, as also the particular importance of drinking. Preprandial exercise to stimulate the appetite is just as important as postprandial resting to avoid diarrhea and the dumping syndrome. A central aspect is the distribution of the food ingested over six to ten small portions. Some nutrients may need to be substituted--for example, vitamin B12, the fat-soluble vitamins, calcium and iron. With increasing time after the operation, alimentation problems usually abate, but in the individual case may persist for years.
A 13-month-old girl experienced an epileptic fit due to hypoglycaemia. She was born with a posterolateral diaphragm defect and at the age of 1.5 months had undergone a Nissen fundoplication with which a gastrostomy was also performed. The tip of the gastrostomy catheter was found to be lying in the bulbus duodeni. Once this had been pulled back, the patient made a good recovery. Dumping syndrome is usually the result of a quicker gastric emptying time or a smaller gastric capacity, and in children it is mostly due to a Nissen fundoplication. In patients fed by tube who exhibit symptoms of dumping syndrome, the position of the feeding tube must be checked before other diagnostic or therapeutic steps are undertaken.
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