DIAGNOSTIC-VALUE OF DUMPING PROVOCATION IN PATIENTS AFTER GASTRIC-SURGERY

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 o f 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 o f late dumping. Factors were heart rate, packed cell volume, breath hy drogen excretion, and blood glucose concentration. Results: An increas e in heart rate of greater than or equal to 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 H-2 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 greater than or equal to 10 beats/mi n and a positive breath hydrogen excretion are sensitive indicators fo r early dumping. Late dumping is better recognized by the occurrence o f subjective symptoms during provocation.