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Rapid Gastric Emptying/Pyloric Dysfunction

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Abstract

Rapid gastric emptying, also known as dumping syndrome, is a condition that results from the transition of undigested food from the stomach to the small intestine. Symptoms include diarrhea, nausea, and epigastric pain, as well as tachycardia, palpitations, and hypotension. Rapid gastric emptying has been linked to gastric surgeries, but recently diabetes mellitus type II and viral illnesses have caused this condition. The diagnosis of dumping syndrome is based on clinical symptoms as well as a confirmed gastric scintigraphy revealing rapid gastric emptying. An oral glucose challenge can also be performed which provokes similar symptoms. The pathophysiology of dumping syndrome is most likely multifactorial, involving hormones (VIP, serotonin, and GLP-1), fluid shifts, and the characteristics of the chyme, or food bolus. Treatment of this syndrome is aimed around dietary modifications as a first-line recommendation. Small, more frequent complex carbohydrate meals with ingestion of liquids 1 h after solid food are suggested. Acarbose, anticholinergic medications, somatostatin, and gastric electrical stimulation have been shown to help with the symptoms of dumping syndrome not controlled with dietary changes. Research in the areas of the etiology, physiology, and treatment of dumping syndrome are a continued interest around the world, and hope to provide more answers to an evolving dysfunction.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Louisville, Louisville, KY, USA

    Alexander Pontikos M.D.

  2. Department of Medicine, University of Louisville, Louisville, KY, USA

    Thomas L. Abell M.D.

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  1. Alexander Pontikos M.D.
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  2. Thomas L. Abell M.D.
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Correspondence to Thomas L. Abell M.D. .

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Editors and Affiliations

  1. Institute of Gastroenterology, Sheba medical Center, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel

    Eytan Bardan

  2. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

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Pontikos, A., Abell, T.L. (2018). Rapid Gastric Emptying/Pyloric Dysfunction. In: Bardan, E., Shaker, R. (eds) Gastrointestinal Motility Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-59352-4_26

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  • DOI: https://doi.org/10.1007/978-3-319-59352-4_26

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