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Risk factors
By Mayo Clinic staff
Several types of surgery increase your risk of dumping syndrome. These include:
- Gastrectomy, in which a portion or all of your stomach is removed. It typically includes removing the pylorus.
- Gastroenterostomy or gastrojejunostomy, in which your stomach is surgically connected directly to your small intestine. Stomach contents then enter the small intestine directly, bypassing the pylorus. Doctors sometimes perform this operation in people with cancer of the stomach.
- Vagotomy, in which the fibers of the vagus nerve to your stomach are cut in order to lower the levels of acid produced by your stomach. The vagus nerve is important in coordinating emptying of stomach contents into the small intestine.
- Fundoplication, which is an operation sometimes performed on people with gastroesophageal reflux disease. It involves wrapping the upper portion of your stomach around the lower esophagus to apply pressure that reduces the reflux of gastric contents into the esophagus. However, on rare occasions, certain nerves to the stomach are unintentionally damaged during surgery, leading to dumping syndrome.
- Gastric bypass surgery (Roux-en-Y operation), which is performed to treat morbid obesity. It surgically creates a stomach pouch smaller than the entire stomach, meaning you're no longer able to eat as much as you once did. It connects the small intestine to this pouch in the form of a gastrojejunostomy.
- Esophagectomy, where all or part of the tube between the mouth and the stomach is removed.
Certain underlying conditions and medications also may make you more susceptible to dumping syndrome. These include:
- Diabetes
- Cyclic vomiting syndrome (CVS)
- Zollinger-Ellison syndrome, which causes severe peptic ulcers
- Metoclopramide (Reglan, Metozolv), sometimes prescribed to ease nausea, vomiting and heartburn
References
- Rapid gastric emptying. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/rapidgastricemptying/. Accessed April 27, 2012.
- Tack J, et al. Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nature Reviews Gastroenterology and Hepatology. 2009;6:583.
- Townsend CM Jr, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-1-4377-1560-6&eid=4-u1.0-B978-1-4377-1560-6..00049-4--s0425. Accessed April 25, 2012.
- Barbara Woodward Lips Patient Education Center. Dietary Guidelines for Managing Dumping Syndrome. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-1-4377-1604-7&eid=4-u1.0-B978-1-4377-1604-7..00142-1--s0130&sid=1301851419&SEQNO=1&bookft=true&bookftset=1&bbSearchType=single&DOCID=2586). Accessed April 26, 2012.
- Hejazi RA, et al. Dumping syndrome: Establishing criteria for diagnosis and identifying new etiologies. Digestive Diseases and Sciences. 2010;55:117.
- Mine S et al. Large-scale investigation into dumping syndrome after gastrectomy for gastric cancer. Journal of the American College of Surgeons. 2010; 211: 628.
- Collazo-Clavell ML (expert opinion). Mayo Clinic, Rochester, Minn. May 1, 2012.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. May 8, 2012.
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