Sympathoadrenal activation and the dumping syndrome after gastric surgery

Dumping symptoms suggest concomitant sympathoadrenal activation. To evaluat e the relation between dumping symptoms and postprandial plasma catecholami ne changes, standardized dumping-provocation tests with use of oral glucose were performed for 16 gastric surgery patients with dumping, for 14 gastri c surgery patients without dumping, and for 14 healthy control patients. Ea rly dumping symptoms were present for all patients with dumping, and late s ymptoms developed in three patients with dumping after glucose ingestion. P atients without dumping and healthy control patients had slight complaints or no complaints. Systolic and diastolic blood pressure remained unaffected for the three groups. Positive breath-hydrogen tests, heart rate increment s, and reactive plasma glucose decrements were present for patients with du mping and for patients without dumping, but not for control patients. Plasm a noradrenaline and adrenaline increased for patients with dumping and for patients without dumping, but not for control patients. The noradrenaline i ncrement was higher for patients with dumping (98%) than for patients witho ut dumping (78%; p < 0.05). The noradrenaline increment was related to the dumping score and to the heart rate increment for the first hour after gluc ose ingestion, whereas the adrenaline increment was related to the plasma g lucose decrement for the third hour. Therefore, dumping symptoms clearly ar e accompanied by postprandial sympathoadrenal activation, but sympathoadren al activation cannot account completely for development of dumping symptoms .