Skip to main content
NCBI home page
Gut logoLink to Gut
. 1989 Dec;30(12):1716–1720. doi: 10.1136/gut.30.12.1716

Studies on the pathogenesis of the early dumping syndrome induced by intraduodenal instillation of hypertonic glucose.

J A Snook 1, A D Wells 1, D R Prytherch 1, D H Evans 1, S R Bloom 1, D G Colin-Jones 1
PMCID: PMC1434447  PMID: 2693232

Abstract

A reaction indistinguishable from the early dumping syndrome was induced in four of nine normal volunteers by intraduodenal instillation of a hypertonic glucose meal. Tachycardia and marked peripheral vasodilatation were demonstrated in 'dumpers' by Doppler ultrasound measurements of the arterial blood flow signal. The dumping reaction was not detectably altered by the addition of guar to the meal. Plasma VIP concentration rose and plasma volume fell to a similar degree in 'dumpers' and 'non-dumpers', suggesting that neither event is an integral component of the dumping mechanism. In contrast, the rates of rise of blood glucose and enteroglucagon concentration were markedly greater in 'dumpers'. The results are inconsistent with the conventional explanation that the early dumping syndrome is caused by a large osmotic fluid shift, but are compatible with a mechanism involving an initial period of intestinal hypermotility.

Full text

PDF
1716

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bieberdorf F. A., Morawski S., Fordtran J. S. Effect of sodium, mannitol, and magnesium on glucose, galactose, 3-O-methylglucose, and fructose absorption in the human ileum. Gastroenterology. 1975 Jan;68(1):58–66. [PubMed] [Google Scholar]
  2. Bloom S. R., Royston C. M., Thomson J. P. Enteroglucagon release in the dumping syndrome. Lancet. 1972 Oct 14;2(7781):789–791. doi: 10.1016/s0140-6736(72)92147-2. [DOI] [PubMed] [Google Scholar]
  3. CHRISTOFFERSSON E., KEWENTER J., KOCK N. G. Intestinal motility during provoked dumping reaction. Acta Chir Scand. 1962 May-Jun;123:405–414. [PubMed] [Google Scholar]
  4. COX H. T., ALLAN W. R. The dumping syndrome. An investigation and a cause. Lancet. 1961 Sep 23;2(7204):672–674. doi: 10.1016/s0140-6736(61)92829-x. [DOI] [PubMed] [Google Scholar]
  5. Clifford P. C., Martin M. F., Sheddon E. J., Kirby J. D., Baird R. N., Dieppe P. A. Treatment of vasospastic disease with prostaglandin E1. Br Med J. 1980 Oct 18;281(6247):1031–1034. doi: 10.1136/bmj.281.6247.1031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Domschke S., Domschke W., Bloom S. R., Mitznegg P., Mitchell S. J., Lux G., Strunz U. Vasoactive intestinal peptide in man: pharmacokinetics, metabolic and circulatory effects. Gut. 1978 Nov;19(11):1049–1053. doi: 10.1136/gut.19.11.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. HINSHAW D. B., JOERGENSON E. J., DAVIS H. A., STAFFORD C. E. Peripheral blood flow and blood volume studies in the dumping syndrome. AMA Arch Surg. 1957 May;74(5):686–693. doi: 10.1001/archsurg.1957.01280110028005. [DOI] [PubMed] [Google Scholar]
  8. Harju E., Heikkilä J., Larmi T. K. Effect of guar gum on gastric emptying after gastric resection. JPEN J Parenter Enteral Nutr. 1984 Jan-Feb;8(1):18–20. doi: 10.1177/014860718400800118. [DOI] [PubMed] [Google Scholar]
  9. Hobsley M. Dumping and diarrhoea. Br J Surg. 1981 Oct;68(10):681–684. doi: 10.1002/bjs.1800681005. [DOI] [PubMed] [Google Scholar]
  10. Jenkins D. J., Bloom S. R., Albuquerque R. H., Leeds A. R., Sarson D. L., Metz G. L., Alberti K. G. Pectin and complications after gastric surgery: normalisation of postprandial glucose and endocrine responses. Gut. 1980 Jul;21(7):574–579. doi: 10.1136/gut.21.7.574. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kaushik S. P., Ralphs D. N., Hobsley M. Influences on the occurrence of dumping syndrome. Am J Gastroenterol. 1983 Mar;78(3):155–158. [PubMed] [Google Scholar]
  12. Krejs G. J., Browne R., Raskin P. Effect of intravenous somatostatin on jejunal absorption of glucose, amino acids, water, and electrolytes. Gastroenterology. 1980 Jan;78(1):26–31. [PubMed] [Google Scholar]
  13. Lawaetz O., Blackburn A. M., Bloom S. R., Aritas Y., Ralphs D. N. Gut hormone profile and gastric emptying in the dumping syndrome. A hypothesis concerning the pathogenesis. Scand J Gastroenterol. 1983 Jan;18(1):73–80. doi: 10.3109/00365528309181562. [DOI] [PubMed] [Google Scholar]
  14. Long R. G., Adrian T. E., Bloom S. R. Somatostatin and the dumping syndrome. Br Med J (Clin Res Ed) 1985 Mar 23;290(6472):886–888. doi: 10.1136/bmj.290.6472.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Long R. G., Christofides N. D., Fitzpatrick M. L., O'Shaughnessy D. J., Bloom S. R. Effects of intravenous somatostatin and motilin on the blood glucose and hormonal response to oral glucose. Eur J Clin Invest. 1982 Aug;12(4):331–336. doi: 10.1111/j.1365-2362.1982.tb02241.x. [DOI] [PubMed] [Google Scholar]
  16. Machella T. E. The Mechanism of the Post-gastrectomy "Dumping" Syndrome. Ann Surg. 1949 Aug;130(2):145–159. [PMC free article] [PubMed] [Google Scholar]
  17. PERNOW B., WALLENSTEN S. THE DUMPING SYNDROME. IV. THE RELATIONSHIP BETWEEN SUBSTANCE P AND THE MOTILITY OF THE SMALL INTESTINE, WITH SPECIAL REFERENCE TO THE DUMPING SYNDROME. Acta Chir Scand. 1964 Nov;128:530–540. [PubMed] [Google Scholar]
  18. Prytherch D. R., Evans D. H. Versatile microcomputer-based system for the capture, storage and processing of spectrum-analysed Doppler ultrasound blood flow signals. Med Biol Eng Comput. 1985 Sep;23(5):445–452. doi: 10.1007/BF02448932. [DOI] [PubMed] [Google Scholar]
  19. Ralphs D. N. The dumping syndrome. Br J Clin Pract. 1981 Sep;35(9):291–293. [PubMed] [Google Scholar]
  20. Saltzman D. A., Rector F. C., Jr, Fordtran J. S. The role of intraluminal sodium in glucose absorption in vivo. J Clin Invest. 1972 Apr;51(4):876–885. doi: 10.1172/JCI106882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Sigstad H. A clinical diagnostic index in the diagnosis of the dumping syndrome. Changes in plasma volume and blood sugar after a test meal. Acta Med Scand. 1970 Dec;188(6):479–486. [PubMed] [Google Scholar]
  22. Thompson D. G., Wingate D. L. Effects of osmoreceptor stimulation on human duodenal motor activity. Gut. 1988 Feb;29(2):173–180. doi: 10.1136/gut.29.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES