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What is which of the following is apt in the management of dumping syndrome ? and explain in detail?
Dumping Syndrome TWO TYPES: Attacks last about 30 minutes 1. Early dumping --immediately after a meal -associated with hypovolemia ((Fluid in blood) and hypotension -caused by hyperosmotic chyme entering duodenum -rapidly extracts large amounts of fluid from circulation into intestine 2. Late dumping---approx. 2 h after a meal -due to hypoglycemia--chyme dumped into intestine results in rapid absorption of glucose into blood - sudden blood hyperglycemia -rapid increase in insulin that overcorrects and results in hypoglycemia --Symptoms: weakness, dizziness and sweating after meals TREATMENT OF DUMPING SYNDROMES * SAME FOR BOTH EARLY & LATE * DIETARY MANIPULATION SMALL DRY MEALS,AVOID FLUIDS WITH HIGH CARBOHYDRATE CONTENT * SOMASTATIN ANALOGUE OCTREOTIDE BEFORE MEALS * REVISIONAL SURGERY * GJ - DRAINAGE IS TAKEN DOWN * PYLOROPLASTY - REPAIRGASTRECTOMY - ANTRERCTOMY&ROUX-EN-Y RECONSTRUCTION ref : bailey and love 27th ed