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Nutritional management of dumping syndrome associated with antireflux surgery
V Khoshoo1, P L Roberts, W A Loe
1Children's Hospital, New Orleans, LA 70118.
Insights
Dumping syndrome in children post-fundoplication surgery can be effectively managed. Nutritional manipulation with complex carbohydrates and fat emulsions resolved symptoms and normalized blood sugar levels in all patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Nutritional Science
Background:
- Dumping syndrome is a potential complication following anti-reflux surgery.
- Rapid gastric emptying can contribute to post-surgical gastrointestinal issues in children.
Purpose of the Study:
- To identify and characterize dumping syndrome in pediatric patients post-fundoplication.
- To evaluate the efficacy of nutritional management for this condition.
Main Methods:
- Diagnosis involved glucose tolerance testing and assessment of gastric emptying.
- Eight children with post-fundoplication dumping syndrome were studied.
- Management focused on dietary changes, specifically complex carbohydrates and fat emulsions.
Main Results:
- All eight children were successfully treated with nutritional manipulation.
- Complete resolution of dumping syndrome symptoms was achieved.
- Normoglycemia was restored without any reported complications.
Conclusions:
- Nutritional therapy is a safe and effective treatment for pediatric dumping syndrome post-fundoplication.
- Early diagnosis and intervention can prevent prolonged symptoms and complications.
Abstract:
Eight children were identified as having dumping syndrome by a glucose tolerance test and evidence of rapid gastric emptying. All had undergone a fundoplication with concomitant feeding gastrostomy placement at 18.4 +/- 17.4 months of age (range, 3 to 54 months). Symptoms suggestive of dumping syndrome occurred 1 to 4 months after surgery. There was considerable delay in diagnosis (3 to 8 months). These children were successfully managed with nutritional manipulation alone, using a combination of a complex carbohydrate and a fat emulsion. Complete resolution of symptoms and normoglycemia was achieved in all the children, without any complications.