A clinical diagnostic index in the diagnosis of the dumping syndrome. Changes in plasma volume and blood sugar after a test meal.

Abstract

Abstract. On the basis of the literature and personal analysis of symptoms and signs in 25 gastrectomized patients, new criteria for the dumping syndrome have been outlined. The clinical diagnosis of the dumping syndrome was based upon a clinical diagnostic index. The method was then applied to 49 partially gastrectomized patients. It is stressed that three of the cardinal symptoms may easily be overlooked, viz. sleepiness, dizziness, and restlessness. Eructation and vomiting are components of the afferent loop syndrome and the small stomach syndrome. After a test meal of hypertonic glucose the percentage changes in plasma volume were measured by Evans blue, hematocrit, and hemoglobin values. All three methods revealed statistically significant differences between dumpers and non-dumpers as regards the mean values of the percentage fall in plasma volume. An increasing fall in plasma volume was generally parallelled by a rising clinical diagnostic index. All patients who showed a fall in plasma volume above 15% were dumpers. Women showed a greater fall in plasma volume and a distinctly larger clinical diagnostic index than men. Statistically significant differences were found between dumpers and non-dumpers as regards the rise in blood sugar after the test meal.