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Dumping syndrome — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Dumping syndromeUSMLE Step 3

A 49-year-old woman who had Roux-en-Y gastric bypass 3 months ago reports cramping, palpitations, flushing, and diarrhea 20 minutes after eating sweets. She has no fever or blood in the stool. Weight loss is progressing as expected. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: B — Rapid delivery of hyperosmolar carbohydrate into the small intestine

Early dumping syndrome after gastric surgery is caused by rapid movement of hyperosmolar food into the small intestine, leading to fluid shifts and vasomotor symptoms.

Reference: American Society for Metabolic and Bariatric Surgery guidance