Gastric dumping syndrome classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]

Overview

Dumping syndrome can be divided into two classifications. These classifications are based on the onset of symptoms after the first meal.

Below is a table differentiating the basic classifications:^[1]^[2]^[3]

Clinical Features	Early Dumping	Late Dumping
Onset	15-30 minutes after a meal	60-180 minutes after a meal
Risk Factor	Bariatric Surgery	Hyperosmolar chyme
Mechanism	Increased release of multiple GI hormones Decrease in gastric volume Impaired retention Possible Pyloric dysfunction	Rapid glucose absorption Incretin release (GLP-1) Amplified insulin secretion
Symptoms	Nausea Bloating Vomiting Diarrhea Borborygmus Epigastric fullness Abdominal cramps Diaphoresis Desire to lie down Headache Flushing Fatigue Lightheadedness Pallor Palpitations Syncope	Tremor Hunger Perspiration Difficulty with concentration Decreased consciousness
Hormones	Vasoactive agents (VIP, Neurotensin) Incretins (GIP, GLP-1) Glucose-modulating hormones (Glucagon, Insulin)	Incretin
Common Complication	Vasomotor symptoms	Hypoglycemia (high Insulin)

↑ Eagon JC, Miedema BW, Kelly KA (1992). "Postgastrectomy syndromes". Surg. Clin. North Am. 72 (2): 445–65. PMID 1549803.
↑ Miedema BW, Kelly KA (1991). "The Roux operation for postgastrectomy syndromes". Am. J. Surg. 161 (2): 256–61. PMID 1990879.
↑ Vecht J, Gielkens HA, Frölich M, Lamers CB, Masclee AA (1997). "Vasoactive substances in early dumping syndrome: effects of dumping provocation with and without octreotide". Eur. J. Clin. Invest. 27 (8): 680–4. PMID 9279532.