Health Dictionary

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.

[1] =”urlwww.practicalgastro.com”>“www.practicalgastro.com” (PDF).

[pmid19264574-2] 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.

[pmid20829078-3] 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.

[pmid23315151-4] 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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