The American Journal of Digestive Diseases

, Volume 12, Issue 1, pp 30–41 | Cite as

Comparison of D(+)xylose with glucose in the study of the pathophysiology of the postgastrectomy dumping syndrome

  • M. C. Geokas
  • J. Solymar
  • I. T. Beck
  • E. R. Phelps
Article
  • 21 Downloads

Conclusions

In an attempt to clucidate the pathophysiology of the postgastrectomy dumping syndrome, iso-osmotic solutions (1682 mosm./L.) of glucose and of D(+)xylose were given by intrajejunal infusion in 6 subjects with an intact stomach and orally to 7 postgastrectomy patients. Symptoms developing after administration of glucose (predominantly vasomotor) lasted longer but were more tolerable than those experienced after D(+)xylose (predominantly gastrointestinal) . D(+)xylose induced less hypokalemia and milder ECG changes, a slight increase in blood-sugar levels (without late hypoglycemia), and a prolonged osmotic effect, as evidenced by protracted changes in plasma volume and osmolarity, total serum solids, and hematocrit.

Subjects with an intact pylorus appeared to be most sensitive; patients who had not experienced dumping after partial gastrectomy were relatively more resistant to either sugar; and those who had had spontaneous symptoms postoperatively experienced more abdominal cramps and diarrhea after D(+)xylose provocation but otherwise had symptoms identical with those of spontaneous episodes.

D(+)xylose, a sugar which is not insulin-dependent, can induce symptoms in persons with an intact stomach as well as in gastrectomized patients subject to spontaneous dumping—a finding which negates the hypothesis that disturbance in carbohydrate metabolism or “exhaustion ” of the islets of Langerhans is the cause of this condition. The role of endogenous insulin after glucose provocation and the mechanism of tolbutamide action in dumping have been discussed.

Keywords

Xylose Hypoglycemia Hypokalemia Tolbutamide Abdominal Cramp 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1967

Authors and Affiliations

  • M. C. Geokas
    • 1
    • 2
  • J. Solymar
    • 1
    • 2
  • I. T. Beck
    • 1
    • 2
  • E. R. Phelps
    • 1
    • 2
  1. 1.From the Department of Medicine (Subdepartment of Gastroenterology)St. Mary's Memorial HospitalCanada
  2. 2.the Department of Investigative MedicineMcGill UniversityMontrealCanada

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