Post-Fundoplication Late Dumping Syndrome in an Adult Diagnosed by Provocative Modified Oral Glucose Tolerance Test
October 2018
in “
The American Journal of Gastroenterology
”
TLDR Late dumping syndrome after fundoplication can be diagnosed with an oral glucose tolerance test and managed with diet changes.
This case report described a rare instance of post-fundoplication late dumping syndrome in a 71-year-old woman, diagnosed using a modified oral glucose tolerance test (OGTT). After undergoing Toupet fundoplication for refractory GERD, the patient experienced symptoms such as abdominal bloating, nausea, and diarrhea, along with hair loss and cracked fingernails. Initial tests for other conditions were negative, and the diagnosis of dumping syndrome was confirmed by rapid gastric emptying on gastric scintigraphy and hypoglycemia observed during the OGTT. The patient improved with dietary changes, highlighting the importance of OGTT in diagnosing dumping syndrome post-fundoplication, especially when symptoms overlap with IBS. The study suggested potential mechanisms like vagal damage or disrupted gastric motility but noted the unclear etiology.
