THE DUMPING SYNDROME
BY H. T. COX CONSULTANT SURGEON, WITHINGTON AND WYTHENSHAWE HOSPITALS, MANCHESTER AND w. R. ALLAN SENIOR SURGICAL REGISTRAR, PRESTON ROYAL INFIRMARY, LANCS.*
THE symptoms of this syndrome in which we are interested are a sensation of warmth, sweating, coidness, palpitation, nausea, lightheadedness, marked weakness, and visual symptoms. It is the symptoms of lightheadedness and marked weakness that are outstanding and can be responsible for clinical collapse. The clinical features of the natural dumping attack suggested vascular dilatation as a cause. Vascular dilatation, as evidenced by plethysmograph recordings on patients' toes, was found to be present, and we suggested that the dumping attack was due to postural hypotension i n those patients unable to compensate for this vasodilatation (Cox and Allan, 1960Allan, , 1961)). The object of this present paper is to confirm that the symptoms of lightheadedness and marked weakness are due to a fall in blood-pressure on standing, and to summarize briefly our work on the dumping syndrome.
We have investigated natural dumping attacks only, that is, attacks of dumping reproduced by giving to the patient the foods he stated bring on the attack.