Medical Surgical Dumping syndrome #1

Question

A client who had an esophagectomy and partial gastrectomy for esophageal cancer, returns for a 6 week follow-up visit. The client is healing well but reports having sudden diarrhea 20-30 minutes after eating the past 6 weeks. What is the most likely cause of what the client is experiencing?

Answers

  1. Gastritis
    • Rationale:

      This answer is not correct because gastritis does not cause diarrhea within 30 minutes after eating. Due to the client’s medical history of having an esophagectomy and partial gastrectomy for esophageal cancer and the report of having diarrhea within 30 minutes after eating, the client is experiencing early dumping syndrome.

  2. Stomach virus
    • Rationale:

      This answer is not correct because the client has had this condition since the surgery. A stomach virus does not occur for 6 weeks. Early dumping syndrome is most commonly a result of surgery on the esophagus or stomach. Late dumping syndrome is commonly caused by excessive insulin release, which can result in hypoglycemia.

  3. Dumping syndrome
    • Rationale:

      This answer is correct because symptoms of sudden diarrhea 30 minutes after eating is called early dumping syndrome. This is most commonly a result of surgery on the esophagus or stomach. Late dumping syndrome is commonly caused by excessive insulin release, which can result in hypoglycemia.

  4. Excessive insulin release
    • Rationale:

      This answer is not correct because early dumping syndrome is most commonly a result of surgery on the esophagus or stomach and symptoms of diarrhea occurs 30 minutes after eating. Late dumping syndrome is commonly caused by excessive insulin release, which can result in hypoglycemia. Late dumping syndrome occurs 1-3 hours after eating.

Overview

Symptoms of sudden diarrhea 30 minutes after eating is called early dumping syndrome. This is most commonly a result of surgery on the esophagus or stomach.

Explanation

Learning Outcomes

Dumping syndrome is rapid gastric emptying. Dumping syndrome occurs as food moves too fast from the stomach to the duodenum of the small intestines, causing symptoms such as nausea, lightheadedness, and diarrhea. The primary concern is dehydration from diarrhea. These symptoms generally occur within about 30 minutes after eating a meal (early dumping syndrome) but can occur as late as 1 to 3 hours after eating (late dumping syndrome). Early dumping syndrome is most commonly a result of surgery on the esophagus or stomach. Late dumping syndrome is commonly caused by excessive insulin release, which can result in hypoglycemia. Generally dumping syndrome is diagnosed based on symptoms and medical history. Treatment includes changes to what and how a person eats, medication, or in some cases, surgery. The first treatment is managing how and when a person eats, such as encouraging the client to eat six small meals a day, lying down after eating, and ingesting more fat, fiber, and protein.

Test Taking Tip

Understanding the difference between early and late dumping syndrome will help determine the correct answer in this question.

Video Rationale