Gastric dumping syndrome diagnostic study of choice: Difference between revisions
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=== Study of choice: === | === Study of choice: === | ||
* [[Glucose tolerance test|Oral glucose tolerance test]] is the ideal study of choice for the [[diagnosis]] of early | * [[Glucose tolerance test|Oral glucose tolerance test]] is the ideal study of choice for the [[diagnosis]] of early dumping syndrome and late dumping syndrome.<ref name="pmid8976007">{{cite journal |vauthors=van der Kleij FG, Vecht J, Lamers CB, Masclee AA |title=Diagnostic value of dumping provocation in patients after gastric surgery |journal=Scand. J. Gastroenterol. |volume=31 |issue=12 |pages=1162–6 |year=1996 |pmid=8976007 |doi= |url=}}</ref><ref name="pmid89760072">{{cite journal |vauthors=van der Kleij FG, Vecht J, Lamers CB, Masclee AA |title=Diagnostic value of dumping provocation in patients after gastric surgery |journal=Scand. J. Gastroenterol. |volume=31 |issue=12 |pages=1162–6 |year=1996 |pmid=8976007 |doi= |url=}}</ref><ref name="pmid26315925">{{cite journal |vauthors=Emous M, Ubels FL, van Beek AP |title=Diagnostic tools for post-gastric bypass hypoglycaemia |journal=Obes Rev |volume=16 |issue=10 |pages=843–56 |year=2015 |pmid=26315925 |doi=10.1111/obr.12307 |url=}}</ref> | ||
* A mixed-meal tolerance [[test]] is the study of choice for the [[diagnosis]] of late dumping syndrome.<ref name="pmid243159902">{{cite journal |vauthors=Salehi M, Gastaldelli A, D'Alessio DA |title=Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass |journal=Gastroenterology |volume=146 |issue=3 |pages=669–680.e2 |year=2014 |pmid=24315990 |pmc=3943944 |doi=10.1053/j.gastro.2013.11.044 |url=}}</ref><ref name="pmid24315990">{{cite journal |vauthors=Salehi M, Gastaldelli A, D'Alessio DA |title=Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass |journal=Gastroenterology |volume=146 |issue=3 |pages=669–680.e2 |year=2014 |pmid=24315990 |pmc=3943944 |doi=10.1053/j.gastro.2013.11.044 |url=}}</ref><ref name="pmid23787216">{{cite journal |vauthors=Khoo CM, Muehlbauer MJ, Stevens RD, Pamuklar Z, Chen J, Newgard CB, Torquati A |title=Postprandial metabolite profiles reveal differential nutrient handling after bariatric surgery compared with matched caloric restriction |journal=Ann. Surg. |volume=259 |issue=4 |pages=687–93 |year=2014 |pmid=23787216 |pmc=3901799 |doi=10.1097/SLA.0b013e318296633f |url=}}</ref> | * A mixed-meal tolerance [[test]] is the study of choice for the [[diagnosis]] of late dumping syndrome.<ref name="pmid243159902">{{cite journal |vauthors=Salehi M, Gastaldelli A, D'Alessio DA |title=Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass |journal=Gastroenterology |volume=146 |issue=3 |pages=669–680.e2 |year=2014 |pmid=24315990 |pmc=3943944 |doi=10.1053/j.gastro.2013.11.044 |url=}}</ref><ref name="pmid24315990">{{cite journal |vauthors=Salehi M, Gastaldelli A, D'Alessio DA |title=Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass |journal=Gastroenterology |volume=146 |issue=3 |pages=669–680.e2 |year=2014 |pmid=24315990 |pmc=3943944 |doi=10.1053/j.gastro.2013.11.044 |url=}}</ref><ref name="pmid23787216">{{cite journal |vauthors=Khoo CM, Muehlbauer MJ, Stevens RD, Pamuklar Z, Chen J, Newgard CB, Torquati A |title=Postprandial metabolite profiles reveal differential nutrient handling after bariatric surgery compared with matched caloric restriction |journal=Ann. Surg. |volume=259 |issue=4 |pages=687–93 |year=2014 |pmid=23787216 |pmc=3901799 |doi=10.1097/SLA.0b013e318296633f |url=}}</ref> | ||
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* After [[ingestion]], a [[pulse]] increase of 10 beats per minute after 30 minutes is diagnostic (most [[Sensitivity (tests)|sensitive]]) | * After [[ingestion]], a [[pulse]] increase of 10 beats per minute after 30 minutes is diagnostic (most [[Sensitivity (tests)|sensitive]]) | ||
OR | OR | ||
* After [[ingestion]], induction of [[Symptom|symptoms]] of dumping syndrome is diagnostic (more specifically) for late | * After [[ingestion]], induction of [[Symptom|symptoms]] of dumping syndrome is diagnostic (more specifically) for late dumping syndrome | ||
|} | |} | ||
{| class="wikitable mw-collapsible" | {| class="wikitable mw-collapsible" | ||
Revision as of 20:45, 14 December 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]
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Overview
The two most sensitive and specific tests used in confirming the clinical suspicion and in diagnosing dumping syndrome are the oral glucose tolerance test and the hydrogen breath test.
Diagnostic Study of Choice
Study of choice:
- Oral glucose tolerance test is the ideal study of choice for the diagnosis of early dumping syndrome and late dumping syndrome.[1][2][3]
- A mixed-meal tolerance test is the study of choice for the diagnosis of late dumping syndrome.[4][5][6]
The comparison table for diagnostic studies of choice for dumping syndrome
| Table | Sensitivity | Specificity |
|---|---|---|
| ✔ Oral glucose provocation | 100% | 92% |
| Hydrogen breath | 100% | ? |
✔= The best test based on the feature
Diagnostic results
| Test | Confirmatory result |
|---|---|
| Oral glucose tolerance test | An increase in the heart rate by 10 beats per minute or more in the first hour after an oral glucose challenge of 50 grams glucose after fasting for 10 hours. |
| Mixed-meal tolerance test | Hypoglycemia between 60 to 180 minutes, after a mixed-meal (lipids, carbohydrates, proteins) after fasting for 10 hours. |
| Hydrogen breath test | A positive hydrogen breath test (a rise of 10 to 15 parts per million) after glucose ingestion. |
Diagnostic criteria
| Oral glucose tolerance test |
|---|
OR
OR |
| Mixed-meal tolerance test |
|---|
|
| Hydrogen breath test |
|---|
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References
- ↑ van der Kleij FG, Vecht J, Lamers CB, Masclee AA (1996). "Diagnostic value of dumping provocation in patients after gastric surgery". Scand. J. Gastroenterol. 31 (12): 1162–6. PMID 8976007.
- ↑ van der Kleij FG, Vecht J, Lamers CB, Masclee AA (1996). "Diagnostic value of dumping provocation in patients after gastric surgery". Scand. J. Gastroenterol. 31 (12): 1162–6. PMID 8976007.
- ↑ Emous M, Ubels FL, van Beek AP (2015). "Diagnostic tools for post-gastric bypass hypoglycaemia". Obes Rev. 16 (10): 843–56. doi:10.1111/obr.12307. PMID 26315925.
- ↑ Salehi M, Gastaldelli A, D'Alessio DA (2014). "Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass". Gastroenterology. 146 (3): 669–680.e2. doi:10.1053/j.gastro.2013.11.044. PMC 3943944. PMID 24315990.
- ↑ Salehi M, Gastaldelli A, D'Alessio DA (2014). "Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass". Gastroenterology. 146 (3): 669–680.e2. doi:10.1053/j.gastro.2013.11.044. PMC 3943944. PMID 24315990.
- ↑ Khoo CM, Muehlbauer MJ, Stevens RD, Pamuklar Z, Chen J, Newgard CB, Torquati A (2014). "Postprandial metabolite profiles reveal differential nutrient handling after bariatric surgery compared with matched caloric restriction". Ann. Surg. 259 (4): 687–93. doi:10.1097/SLA.0b013e318296633f. PMC 3901799. PMID 23787216.