Postprandial syndrome

Introduction Postprandial syndrome: refers to the gastric emptying after gastrectomy, glucose is quickly absorbed by the intestinal mucosa, resulting in a sudden increase in blood sugar, stimulated a series of hypoglycemia caused by excessive islet secretion of insulin. Early postprandial symptom groups mainly include two groups of symptoms: one group is gastrointestinal symptoms, the most common are upper abdominal fullness discomfort, nausea, hernia, abdominal pain, abdominal distension and bowel sounds, sometimes accompanied by vomiting and diarrhea. The spit is alkaline with bile; the other is symptoms of the circulatory system, palpitations, tachycardia, sweating, dizziness, paleness, fever, weakness, and decreased blood pressure.

Cause

The beginning of the early dumping syndrome is due to the rapid entry of food into the small intestine, the migration of fluids into the gastrointestinal tract to maintain normal osmolality in the gastrointestinal tract, and hypovolemia leading to somatic symptoms. However, the mechanism of "high osmotic pressure theory" in the occurrence of dumping syndrome is also questionable because the amount of fluid that migrates is only 300-700 ml, and the acute loss of such a volume of liquid is usually easily tolerated. Hinshaw first reported the expansion of peripheral blood vessels when oral glucose induced dumping, rather than the shrinkage that was traditionally considered to be in a state of hypovolemia. Peripheral venous and splenic vein dilatation may be an important factor in the appearance of physical symptoms and signs during early onset. Some studies have shown the role of the serotonin and kinin-bradykinin systems in the onset of dumping, but the evidence is not compelling. After taking glucose, the patient's glucagon was significantly increased, and vasoactive intestinal peptide, YY peptide, pancreatic polypeptide and neurotensin also showed similar reactions. Late dumping syndrome is caused by reactive somatic hypoglycemia. Rapid food intake into the small intestine and rapid absorption of glucose lead to high insulin and hyperglycemia reactions, and high insulin causes secondary hypoglycemia.

an examination

Related inspection

Glucose insulin

Often eaten for 90-180 minutes (especially eating a lot of carbohydrates), after the onset, the performance is extremely weak, weak, dizziness, palpitation, trembling, cold sweat, severe cases can occur disturbance of consciousness. There were no obvious positive signs in the examination. Before the onset, plasma insulin is often 3-4 times higher than that of normal people, and blood sugar is significantly reduced at the time of onset. In a few cases, there may be a dumping syndrome, followed by postprandial hypoglycemia. Therefore, the detection of blood sugar is the main method of examination of this disease.

Differential diagnosis

Extra-pancreatic tumor

2. Functional hypoglycemia

3. Chronic adrenal insufficiency (Addison disease)

Lychee disease

5. Drug-induced hypoglycemia

6. Glucose utilization or loss of too much

7. Insufficient food intake

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