ISSN:
1573-2568
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Conclusions In an attempt to clucidate the pathophysiology of the postgastrectomy dumping syndrome, iso-osmotic solutions (1682 mosm./L.) of glucose and of D(+)xylose were given by intrajejunal infusion in 6 subjects with an intact stomach and orally to 7 postgastrectomy patients. Symptoms developing after administration of glucose (predominantly vasomotor) lasted longer but were more tolerable than those experienced after D(+)xylose (predominantly gastrointestinal) . D(+)xylose induced less hypokalemia and milder ECG changes, a slight increase in blood-sugar levels (without late hypoglycemia), and a prolonged osmotic effect, as evidenced by protracted changes in plasma volume and osmolarity, total serum solids, and hematocrit. Subjects with an intact pylorus appeared to be most sensitive; patients who had not experienced dumping after partial gastrectomy were relatively more resistant to either sugar; and those who had had spontaneous symptoms postoperatively experienced more abdominal cramps and diarrhea after D(+)xylose provocation but otherwise had symptoms identical with those of spontaneous episodes. D(+)xylose, a sugar which is not insulin-dependent, can induce symptoms in persons with an intact stomach as well as in gastrectomized patients subject to spontaneous dumping—a finding which negates the hypothesis that disturbance in carbohydrate metabolism or “exhaustion ” of the islets of Langerhans is the cause of this condition. The role of endogenous insulin after glucose provocation and the mechanism of tolbutamide action in dumping have been discussed.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02235225
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