The Dumping Syndrome--I: I. Factors Responsible for the Symptoms

The dumping syndrome is one cause of an unsatisfactory result after the operation of subtotal gastrectomy. Symptoms come on towards the end of or shortly after meals, the main features being feelings of abdominal distension, often accompanied by borborygmi, and of extreme exhaustion with faintness, dizziness, sweating, and p:lpitations. These symptoms, which are exacer- bated by standing and relieved by recumbency, last for some 30-45 minutes. A severe attack may culminate in the passage of a loose motion. The onset or fear of symptoms restricts the size of meals, and many patients notice that carbohydrate food is particularly apt to produce symptoms. The true incidence of the condition is difficult to assess, because in the first few weeks after gastrectomy many patients experience these symptoms to a greater or less extent, but in the majority a spontaneous improvement occurs. The syndrome may also, but less often, develop after gastro-enterostomy.