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Postgastroresection syndrome
Last reviewed: 07.07.2025
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[ Dumping-post-gastrectomy syndrome
Dumping-postgastrectomy syndrome is the most common functional disorder after gastric surgery. It is often combined with other disorders. The main links are: rapid evacuation of food masses from the stomach stump, rapid passage through the small intestine, dysfunction of the pancreas, gland, vasomotor disorders of blood circulation.
Characterized by severe weakness, sweating, headache, dizziness, palpitations, desire to lie down, often cutting pains in the upper abdomen or throughout the abdomen, increased intestinal peristalsis with diarrhea. The severity depends on the severity of the disorder. In mild cases, attacks occur 1-2 times a week, 10-15 minutes after eating, usually after eating sweet and dairy foods, and last 10-20 minutes. In moderate cases, attacks occur almost daily, lasting up to an hour. In severe cases, they occur after each meal, last up to two hours, the patient loses significant weight, even light physical activity is impossible due to constant weakness, and neuropsychiatric disorders often occur. The diagnosis is confirmed by X-ray examination of the stomach (preferably FGDS). In severe cases, the patient is sent to a surgical hospital.
Hypoglycemic post-gastrectomy syndrome
Its development is based on sharp fluctuations in blood sugar levels with the development of hypoglycemia, up to hypoglycemic coma. It is often combined with dumping syndrome and is based on dysfunction of the pancreas, especially the insular apparatus, or morphological changes occur in it according to the type of pancreatodystrophy (usually sclerosis).
The attack begins 2-3 hours after eating, accompanied by dizziness, weakness, a sharp feeling of hunger, euphoria; patients note sucking pain in the epigastrium, tremors, sweating, palpitations. A decrease in blood pressure and bradycardia are characteristic. The phenomena are quickly stopped by taking a small amount of food, especially carbohydrates. The diagnosis is based on the clinical picture and laboratory data from a blood test for sugar (before and after eating).
Reflux syndrome (adductor loop syndrome)
It most often develops after the Bilroth II resection operation. It is based on a violation of the evacuation of contents from the afferent loop with the contents being thrown into the gastric stump and dyskinesia of the efferent loop. As a result, anastomosis, reflux gastritis, jejunitis develop, there may be a relapse of the ulcer, dysfunction of the liver and pancreas.
The clinical picture is characterized by bursting pains in the epigastrium and right hypochondrium, a feeling of heaviness, which intensify after eating. The intensity of the pain gradually increases, and they end with profuse vomiting of bile, sometimes with an admixture of ingested food, which brings significant relief. External manifestations are sometimes: protrusion of the swollen afferent loop in the right hypochondrium, giving an asymmetry of the abdomen, which disappears after vomiting, yellowness of the sclera, weight loss, up to exhaustion. Vomiting can be up to several times a day, and bile can be excreted per day up to 500-700 ml. The diagnosis is confirmed by X-ray examination of the stomach and FGDS, a complete blood biochemistry and salt composition are examined in the laboratory. The patient should be sent to a surgical hospital for a corrective operation.
Chronic post-gastrectomy syndrome
It occurs as a painful form of chronic pancreatitis. It is often combined with reflux syndrome and dumping syndrome. Treatment is conservative.
Metabolic post-gastrectomy syndrome
It is combined with all the above syndromes and is expressed in a violation of protein metabolism, which is expressed in the patient's weight loss, the development of chronic water-electrolyte disorders, the development of iron deficiency and B12-deficiency anemia, etc. Treatment is conservative.