The most common physical side effects from this surgery are development of early or late dumping syndrome

Question

Describe each of these syndromes, including symptoms the patient might experience, etiology of the symptoms, and standard interventions for preventing/treating the symptoms.

Answer 1

Early dumping syndrome:
• Occurs approximately 10-20 minutes after eating.
• Symptoms include flushing, increased heart rate, explosive diarrhea, and also hypotension (leading to dizziness, weakness, and possible fainting).
• These symptoms are caused when a high carbohydrate intake—which is hyperosmolar—enters the small intestine over a short period of time.
- The hyperosmolar load pulls water into the small intestine.
- This decreases plasma volume, resulting in hypotension.
- The rush of fluid into the small intestine results in diarrhea.
Late dumping syndrome:
• Occurs anywhere from 1 to 3 hours after a meal.
• Symptoms include feeling confused, feeling light-headed, perspiration, shakiness, and weakness.
• Etiology stems from the rapid movement of carbohydrate into the small intestine.
• Rapid absorption stimulates a large release of insulin and hypoglycemia results.
Prevention of the dumping syndromes is based on a slow progression of an oral diet with avoidance of simple carbohydrates.
• It is important to ensure adequate kcal and protein for postoperative healing.
• First meals post-operatively should include a protein source with only 1-2 foods at a time.
• Liquids should be consumed 30-45 minutes after eating solid foods.
• Lying down after eating may also assist.
• Overall, food choices should exclude simple sugars.
• Chewing foods well and eating slowly may help
• Avoiding extreme temperatures of foods
• Intake should be divided among 6-8 small meals per day and overall should emphasize protein foods.
• A slightly higher fat intake than the usual adult recommendation may be needed to meet energy requirements.
• Foods high in soluble fiber may also assist in slowing gastric emptying.
• Liquid multivitamins and B12 supplementation should be initiated.