Gastric dumping syndrome diagnostic study of choice: Difference between revisions
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=== Study of choice: === | === Study of choice: === | ||
* Oral glucose tolerance test is the study of choice for the diagnosis of early dumping syndrome and late dumping syndrome. | * Oral glucose tolerance test is the ideal study of choice for the diagnosis of early dumping syndrome and late dumping syndrome. | ||
* A mixed-meal tolerance test is the study of choice for the diagnosis of late dumping syndrome. | * A mixed-meal tolerance test is the study of choice for the diagnosis of late dumping syndrome. | ||
==== The comparison table for diagnostic studies of choice for Dumping syndrome ==== | ==== The comparison table for diagnostic studies of choice for Dumping syndrome ==== | ||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |Table | ! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |Table | ||
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===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
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!Test | |||
!Confirmatory result | |||
|- | |||
|'''Oral glucose tolerance test''' | |||
|An increase in the heart rate by 10 beats per minute or more in the first hour after an oral glucose challenge of 50 grams glucose after fasting for 10 hours. | |||
|- | |||
|'''Mixed-meal tolerance test''' | |||
|Hypoglycemia between 60 to 180 minutes, after a mixed-meal (fats, carbohydrates, proteins) after fasting for 10 hours. | |||
|- | |||
|'''Hydrogen breath test''' | |||
|A positive Hydrogen breath test after glucose ingestion. | |||
|} | |||
=== Diagnostic Criteria === | === Diagnostic Criteria === | ||
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* The patient fasts overnight | * The patient fasts overnight | ||
* An oral glucose load of 50 grams or 75 grams in solution is given | * An oral glucose load of 50 grams or 75 grams in solution is given | ||
* Readings of the heart rate and blood pressure are taken before the ingestion | |||
* Blood is drawn before the ingestion | |||
* After ingestion, every 30 minutes until 180 minutes, readings and blood are taken | |||
* After ingestion, a hematocrit >3% before 30 minutes is diagnostic (less sensitive) | |||
OR | |||
* After ingestion, a pulse increase of 10 beats per minute after 30 minutes is diagnostic (most sensitive) | |||
OR | |||
* After ingestion, induction of symptoms of dumping syndrome is diagnostic (more specifically) for late dumping syndrome | |||
|} | |||
{| class="wikitable" | |||
!Mixed-meal tolerance test | |||
|- | |||
| | |||
* The patient fasts overnight | |||
* A meal consisting of fats, proteins and carbohydrates is given | |||
* Readings of the heart rate and blood pressure are taken before the ingestion | * Readings of the heart rate and blood pressure are taken before the ingestion | ||
* Blood is drawn before the ingestion | * Blood is drawn before the ingestion | ||
* | * After ingestion, every 30 minutes until 2 hours, readings and blood are taken | ||
* | * After ingestion, hypoglycemia between 60 to 180 minutes is diagnostic | ||
|} | |} | ||
Revision as of 03:25, 29 November 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Differentiating Gastric dumping syndrome from other Diseases |
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Overview
The two most sensitive and specific tests used in confirming the clinical suspicion and in diagnosing Dumping syndrome. They are the oral glucose tolerance test and the Hydrogen breath test.
Diagnostic Study of Choice
Study of choice:
- Oral glucose tolerance test is the ideal study of choice for the diagnosis of early dumping syndrome and late dumping syndrome.
- A mixed-meal tolerance test is the study of choice for the diagnosis of late dumping syndrome.
The comparison table for diagnostic studies of choice for Dumping syndrome
| Table | Sensitivity | Specificity |
|---|---|---|
| ✔ Oral glucose provocation | 100% | 92% |
| Hydrogen breath | 100% | ? |
✔= The best test based on the feature
Diagnostic results
| Test | Confirmatory result |
|---|---|
| Oral glucose tolerance test | An increase in the heart rate by 10 beats per minute or more in the first hour after an oral glucose challenge of 50 grams glucose after fasting for 10 hours. |
| Mixed-meal tolerance test | Hypoglycemia between 60 to 180 minutes, after a mixed-meal (fats, carbohydrates, proteins) after fasting for 10 hours. |
| Hydrogen breath test | A positive Hydrogen breath test after glucose ingestion. |
Diagnostic Criteria
| Oral glucose tolerance test |
|---|
OR
OR
|
| Mixed-meal tolerance test |
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|
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