Review
Therapeutic value of octreotide for patients with severe dumping
syndrome
a review of randomised controlled trials
J Li-Ling, M Irving
Department of
Surgery, Medical School, University of Newcastle upon Tyne, UK
Correspondence to: Professor Sir Miles Irving, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK m.h.irving@ncl.ac.uk
Submitted 19 April
2000;
Accepted 7 November 2000
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
Approximately 10%-50% of patients develop some
manifestations of the dumping syndrome after gastric surgery. Among
them, 5%-10% have clinically significant symptoms, and 1%-2% are
debilitated by them.1 Early dumping, typically starting
10-30 minutes after a meal, usually involves both vasomotor and
gastrointestinal complaints such as sweating, palpitation, weakness and
faintness, abdominal bloating, cramping, and profound diarrhoea. Late
dumping, often occurring 2-3 hours postprandially, involves mainly
vascular complaints characterised by perspiration, palpitation, mental
confusion, and sometimes syncope. It is estimated that, among all
affected patients, 75% have early dumping symptoms. The symptoms of
early dumping probably result from rapid emptying of hyperosmolar chyme into the small bowel leading to a large fluid shift from the
intravascular space into the intestinal lumen, with consequent rapid
small bowel distension and an increase in both the amplitude and
frequency of bowel contractions. Late dumping is a consequence of
reactive hypoglycaemia resulting from an exaggerated
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