Stomach Disorders: Dumping Syndrome Flashcards
What is Dumping Syndrome?
• A condition that occurs when food is emptied (dumped) from the stomach into the small intestine too quickly
When does dumping syndrome occur?
• Commonly seen after gastric surgeries
What are the two phases for symptoms of dumping syndrome?
- Early: 10-30mins right after a meal
- Late: 1-3hrs after a meal
What are the percentages of pts reporting early vs late dumping syndrome?
- 75% = early s/s
- 25% = late s/s
What are the s/s of early dumping syndrome?
- N/V
- Gas
- Bloating
- Cramping
What are the s/s of late dumping syndrome
- Hypoglycemia
- vertigo/syncope
- Pallor/Sweating
- Tachycardia/palpitations
- Diarrhea
What causes N/V in dumping syndrome?
• Not enough capacity in stomach
What causes vertigo and syncope w/ dumping syndrome?
• Blood flow prioritized to stomach, reducing flow to brain
How does dumping syndrome result in hypoglycemia?
• The food passes before insulin can be produced and absorbed causing sugar to drop
What diet changes can help slow gastric emptying and minimize dumping syndrome s/s?
- Eat freq, small meals that are chewed well or chopped up
- Limit concentrated sugars (cakes, pies, sweetened fruit juices, soft drinks)
- No artificial sweeteners (Splenda ok)
- No liquids w/ meals. 30 mins before and after
- Rest/lie down for 30mins after meal
What are the diet composition guidelines for dumping syndrome?
- Every meal should contain
- Complex carbs
- High fiber foods
- Small amount of extra fats
- Protein
What types of foods are high in fiber?
• Beans, lentils, fruits, vegetables, whole grains
What types of foods are good for fats?
• Avocado, nuts and nut butter
What types of foods are good for protein?
• Meat, poultry, fish, eggs, dairy, tofu, nut butters
With dumping syndrome, what can artificial sweeteners cause?
• Diarrhea, gas, bloating
Why are fruits that are high in pectin (peaches, apples, plums) helpful with dumping syndrome?
• It increases chyme viscosity and slows down gastric emptying/digestion
What three vitamins are important to eat or take supplements for w/ dumping syndrome?
- Vit B12
- Iron
- Calcium
Why would Octreotide (standostatin) be given to a pt with dumping syndrome?
• It is an antidiarrheal
What medication can be given to manage hypoglycemia as a result of dumping syndrome and how does it work?
- Acarbose
- It works by slowing the action of certain chemicals that break down food to release glucose (sugar) into your blood.
- Slowing food digestion helps keep blood glucose from rising very high after meals.
- Allows insulin time to be released
What is the nutritional therapy for postprandial hypoglycemia?
- Immediate ingestion of sugared fluid/candy
- Lower carb intake
- Moderate protein and fats
What is Bariatric Surgery?
- Removal of part of the stomach to reduce of gastric capacity or absorption in morbidly obese patients
- BMI >4, or BMI >35 w/ other risk factors
What is a key bariatric post-op complication to monitor for?
- Monitor for dumping syndrome
What is our pt teaching for bariatric surgery pts?
- Chew food slowly and completely
- Eat small freq meals
- Do NOT consume liquids with meals
- DO recline after meals to slow gastric emptying (with dumping syndrome)
- Keep diet low in sugar, fat and carbs
- Take vitamin/mineral supplements as directed
What is a gastric balloon?
- Also known as an intragastric balloon or a stomach balloon
- It is an inflatable medical device that is temporarily placed into the stomach to help reduce weight (can also be used to stop bleeding).
- It is designed to help provide weight loss when diet and exercise have failed, and surgery is not wanted or not recommended for the patient.
What is the normal capacity of the stomach?
- 1000-5000mL
Bariatric surgery reduction can reduce stomach capacity to what range?
- 800-1000mL
What are three common bariatric surgeries performed?
- Gastric pouch
- Gastric band
- Gastric sleeve
Describe the gastric pouch.
- Stomach is split in two
- Small intestine is cut after jejunum with distal end being attached to the pouch and the proximal end sutured back on downstream to be able to deliver digestive juices
Describe the gastric band.
- A silicone device placed around the upper section of the stomach, creating a small pouch above the band and thereby restricting the amount of food that can be comfortably eaten.
Describe the gastric sleeve.
- Procedure that removes 75-80% of the stomach. It is now the most commonly performed bariatric procedure in world.
