Diagnostic Value of Dumping Provocation in Patients after Gastric Surgery
Abstract
Background In patients after gastric surgery it is often difficult to discern symptoms from dumping from other postcibal complaints. Strict criteria for dumping provocation test have not been defined. Methods The sensitivity and specificity of a dumping provocation using 50 g of glucose orally was assessed in 48 patients after gastric surgery, of whom 19 had a typical history of early dumping and 11 had a history of late dumping. Factors were heart rate, packed cell volume, breath hydrogen excretion, and blood glucose concentration. Results An increase in heart rate of > or = 10 beats/min in the 1st h had a sensitivity of 100% and a specificity of 94% in detecting early dumping. An early rise in breath H2 excretion showed a sensitivity of 84% and specificity of 94%. The nadir blood glucose concentration was not a sensitive or specific indicator for late dumping. Conclusions Both an increase in heart rate of > or = 10 beats/min and a positive breath hydrogen excretion are sensitive indicators for early dumping. Late dumping is better recognized by the occurrence of subjective symptoms during provocation.
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Gastric emptying studies generally have low sensitivity and specificity, probably because the process of rapid gastric emptying occurs soon after ingestion, a phase that is not adequately assessed in most studies.
“However, gastric emptying studies generally have low sensitivity and specificity, probably because the process of rapid gastric emptying occurs soon after ingestion, a phase that is not adequately assessed in most studies.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [37]
The duration of the entire gastric emptying study of up to 4 h is integrated into a single value (half emptying time), which may neutralize the rapid initial emptying effect.
“Furthermore, the duration of the entire study of up to 4 h is integrated into a single value (half emptying time), which may neutralize the rapid initial emptying effect (3,15,37).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [37]
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- Authors
- Van Der Kleij, F. G. H., Vecht, J., Lamers, C. B. H. W., & Masclee, A. A. M.
- Affiliations
- Dept. of Gastroenterology-Hepatology, University Hospital Leiden, Leiden, The Netherlands
- Leiden University Medical Center (NL)
- Venue
- Scandinavian Journal of Gastroenterology
- Publisher
- Informa UK Limited
- Published
- 1996-01
- Volume
- 31
- Issue
- 12
- Pages
- 1162-1166
- ISSN
- 0036-5521 (ISSN-L)
- 1502-7708
- OpenAlex
- W1985488167
- Cited by
- 83
- References
- 25
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 7 · 2022: 3 · 2021: 6 · 2020: 6 · 2019: 9 · 2018: 4 · 2017: 6 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- gastric surgery, heart rate, breath hydrogen excretion, blood glucose, sensitivity and specificity
- MeSH terms
- Adult, Aged, Aged, 80 and over, Dumping Syndrome, Female, Glucose, Humans, Male, Middle Aged, Postoperative Complications, Reference Values, Sensitivity and Specificity, Stomach
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