Diazoxide for the treatment of hypoglycaemic dumping syndrome

Dumping syndrome is a commonly recognized complication after gastric and oesophageal surgery.1 It is characterized by postprandial early gastrointestinal and vasomotor symptoms followed by late hypoglycaemia. Early dumping symptoms include abdominal pain, bloating, nausea, vomiting, flushing, tachycardia and hypotension. Late dumping symptoms which occur 1–3 h after food are thought to be due to excess insulin secretion that results in hypoglycaemia. Management of hypoglycaemia in dumping syndrome can be challenging and the therapeutic options are dietary modifications, acarbose, octreotide and diazoxide all providing varying degrees of symptomatic relief.1 Dumping syndrome is likely to become more prevalent due to the pandemic of obesity and associated use of bariatric surgery. Diazoxide has been occasionally used with some success in post-bariatric surgery dumping syndrome2 but there are no reports of its effective use in treating hypoglycaemia associated with primary gastric surgery. We describe three patients with hypoglycaemic dumping syndrome after different gastric surgeries that were successfully treated with diazoxide.