Dumping Syndrome: Establishing Criteria for Diagnosis and Identifying New Etiologies

  • Reza A. Hejazi
  • Harshal Patil
  • Richard W. McCallum
Original Article

DOI: 10.1007/s10620-009-0939-5

Cite this article as:
Hejazi, R.A., Patil, H. & McCallum, R.W. Dig Dis Sci (2010) 55: 117. doi:10.1007/s10620-009-0939-5

Abstract

Aims

To investigate the current incidence and identify the current etiologies of rapid gastric emptying (dumping syndrome) in patients with a spectrum of gastrointestinal symptoms, including nausea, vomiting, abdominal pain, or diarrhea.

Methods

The results for a 4-h radionuclide gastric emptying test (GET) using a standardized scintigraphic technique were reviewed in 545 patients to see which patients met criteria for rapid gastric emptying, defined as >50% emptying of isotope-labeled solid meal at 1 h.

Results

Forty-eight of 545 (8.8%) patients (28 females, mean age 46 ± 2 years, range 32–58 years) had rapid GET. Seventeen of 59 (35%) met Rome III diagnostic criteria for cyclic vomiting syndrome (CVS). Twelve of these 59 (25%) patients were regarded as non-ulcer dyspepsia and six (13%) had dyspepsia in the setting of diabetes mellitus. Five (10.5%) were post-fundoplication surgery, where an accidental vagotomy was confirmed by sham meal challenge; previous gastric bypass surgery for obesity had been performed in three (6%) patients. Five (10.5%) patients with unexplained abdominal pain and diarrhea had the working diagnosis of irritable bowel syndrome.

Conclusions

Rapid gastric emptying can be identified in a sizeable subset (9%) of patients with unexplained nausea, vomiting, abdominal pain, and diarrhea when criteria are applied to the standardized scintigraphic gastric emptying meal.

Keywords

Gastric emptying test Dumping syndrome Etiology 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Reza A. Hejazi
    • 1
  • Harshal Patil
    • 1
  • Richard W. McCallum
    • 1
    • 2
  1. 1.Department of Medicine, Division of GastroenterologyKansas University Medical CenterKansas CityUSA
  2. 2.Department of Internal Medicine, Paul L. Foster School of MedicineTexas Tech University Health Sciences CenterEl PasoUSA

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