The Dumping Reaction Studied by EEG and Respiratory Variables

Abstract

Twenty-seven patients with dumping complaints after partial gastrectomy for peptic ulcer were examined before and during dumping provocation with hypertonic glucose solution.

A continuous and simultaneous registration of EEG and respiration, including spirography and capnography, was performed. The stage of wakefulness, the breathing pattern, and the sensitivity to carbon dioxide were studied and related to the symptoms experienced by the individuals examined.

The dumping cases showed a lower mean standard threshold of ventilatory response to carbon dioxide than that found in a group of normals.

Following glucose a two-phasic change in respiration as well as in level of wakefulness was found. During the first twenty minutes after dumping provocation with hypertonic glucose a disturbed irregular ventilatory pattern was usually present, in severe cases even marked hyperventilation. At the same time there were signs of increased wakefulness resembling that during tense alertness. It was followed by a successive decrease in level of wakefulness. Drowsiness and sleep pattern appeared in the EEG as well as in respiration, culminating about one hour after the glucose intake.

It is concluded that nervous structures in the brain stem are primarily involved in the dumping reaction. During the initial phase this may be due to an increase in afferent neuronal drive on the reticular activating system as a whole, including the brain stem centers of respiration. During the next phase, when the disturbed homeostasis is re-established, the level of wakefulness decreases.

Index-words:

• Stomach
• dumping syndrome
• electroencephalography
• respiratory function
• gastrectomy