Gastric dumping syndrome screening
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]
Overview
There is insufficient evidence to recommend routine screening for dumping syndrome. Screening is done after exposure to the risk factors for dumping syndrome. The Sigstad score is a table of symptoms used to differentiate dumpers from non-dumpers (healthy). Other methods have been used but were never formally validated.
Screening
There is insufficient evidence to recommend routine screening for dumping syndrome.
Sigstad score
- The Sigstad diagnostic score system is used to determine dumping syndrome versus non-dumping syndrome.[1]
- A score greater than 7 suggests dumping.
- A score less than 4 is suggest other diseases.
| Sigstad score | |
|---|---|
| Shock | +5 |
| Fainting, syncope, unconsciousness | +4 |
| Desire to lie or sit down | +4 |
| Breathlessness, dyspnea | +3 |
| Weakness, exhaustion | +3 |
| Sleepiness, drowsiness, apathy, falling asleep | +3 |
| Palpitation | +3 |
| Restlessness | +2 |
| Dizziness | +2 |
| Headaches | +1 |
| Feeling of warmth, sweating, pallor, clammy skin | +1 |
| Nausea | +1 |
| Abdominal fullness, meteorism | +1 |
| Borborygmus | +1 |
| Eructation | −1 |
| Vomiting | −4 |
Visick classification
The Visick classification is used to determine the severity of dumping syndrome.
Arts questionnaire
The Arts’ questionnaire helps distinguish early dumping syndrome from late dumping syndrome:[2]
- This questionnaire is scored on a 4-point Likert scale.
| Early dumping symptoms | Late dumping symptoms |
|---|---|
| Sweating | Sweating |
| Flushing | Palpitations |
| Dizziness | Hunger |
| Palpitations | Drowsiness/unconsciousness |
| Abdominal pain | Tremor |
| Diarrhea | Irritability |
| Bloating | |
| Nausea |
Visual analogue scale
- This is a survey used to determine early versus late dumping syndrome.[3]
- A score greater than 10 mm suggests dumping.
Dumping symptom rating scale
- Helps identify dumping symptoms.[4]
- The questionnaire consists of 15 total questions.
- This questionnaire is scored on a 6 to 7-point Likert scale.
- It is used 6-12 months after surgery.
| Question# | Question |
|---|---|
| Q1 | Have you during the past week, been bothered by fatigue shortly (about 10-30 minutes after meals? |
| Q2 | Have you during the past week, been bothered by palpitations? shortly (about 10-30 minutes) after meals. |
| Q3 | Have you during the past week, been bothered by sweating, flushing? shortly (about 10-30 minutes) after meals. |
| Q4 | Have you during the past week, been bothered by cold sweats, paleness? shortly (about 10-30 minutes) after meals. |
| Q5 | Have you during the last week felt the need to lie down for a while? shortly (about 10-30 minutes) after meals. |
| Q6 | Have you during the last week suffered from diarrhea? shortly (about 10-30 minutes) after meals. |
| Q7 | Have you during the last week suffered from nausea and / or vomiting feeling? shortly (about 10-30 minutes) after meals. |
| Q8 | Have you during the last week suffered from “cramp” in the stomach? shortly (about 10-30 minutes) after meals. |
| Q9 | Have you during the last week suffered from fainting-esteem and / or shaking? shortly (about 10-30 minutes) after meals. |
| Q10 | Have you during the last week suffered from pain, vomiting, “stop, if you drink fluids in moderate amount in relation to a meal? |
| Q11 | If you during the last week hastily drank heavily sweetened drinks do you have then suffered problems in the abdomen, faintness or fatigue? |
| Q12 | Over the past two week, how often have you experienced the following problems? shortly (about 10-30 minutes) after meals. •Fatigue☐☐☐☐☐☐ •Palpitations☐☐☐☐☐☐ •Sweating/Flushing☐☐☐☐☐☐ •Cold sweats☐☐☐☐☐☐ •Need to lie down☐☐☐☐☐☐ •Diarrhea☐☐☐☐☐☐ •Nausea/vomiting feelings☐☐☐☐☐☐ •Cramp in the stomach☐☐☐☐☐☐ •Fainting-esteem “shaky”☐☐☐☐☐☐ |
| Q13 | Do you avoid certain foods to avoid or alleviate problems associated with food? Yes or No? |
| Q14 | If you answered Yes to question 13, mark a cross on the foods that you avoid to avoid or alleviate problems associated with food. ☐Fatty foods ☐Whole meat ☐High-fiber ☐Fruits ☐Sugar-rich products ☐Raw vegetables ☐Sweet drinks ☐Milk and milk products |
| Q15 | If you filled out food in question 14, which inconveniences, troubles or problems is it that you mainly avoid?_______________________________________________________________ |
References
- ↑ name=”urlwww.practicalgastro.com”>“www.practicalgastro.com” (PDF).
- ↑ Arts J, Caenepeel P, Bisschops R, Dewulf D, Holvoet L, Piessevaux H, Bourgeois S, Sifrim D, Janssens J, Tack J (2009). “Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping”. Clin. Gastroenterol. Hepatol. 7 (4): 432–7. doi:10.1016/j.cgh.2008.11.025. PMID 19264574.
- ↑ Mine S, Sano T, Tsutsumi K, Murakami Y, Ehara K, Saka M, Hara K, Fukagawa T, Udagawa H, Katai H (2010). “Large-scale investigation into dumping syndrome after gastrectomy for gastric cancer”. J. Am. Coll. Surg. 211 (5): 628–36. doi:10.1016/j.jamcollsurg.2010.07.003. PMID 20829078.
- ↑ Laurenius A, Olbers T, Näslund I, Karlsson J (2013). “Dumping syndrome following gastric bypass: validation of the dumping symptom rating scale”. Obes Surg. 23 (6): 740–55. doi:10.1007/s11695-012-0856-0. PMID 23315151.
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