A syndrome is defined as a group of symptoms that occur together and result in a pathological condition. Postgastrectomy syndromes refer to a variety of conditions, which develop after a gastrectomy. A gastrectomy is defined as the surgical removal of part or all of the stomach.

The diagnostic code refers to conditions that develop following gastric surgery.

A condition developing after gastric surgery is termed the dumping syndrome, which is characterized by rapid emptying of stomach contents into the small intestine. The syndrome has a sudden onset, usually within a few minutes to 45 minutes after eating. Manifestations include: nausea; weakness; sweating; palpitations; dizziness; flushing of the face; gurgling; and splashing sounds usually heard over the large intestine (borborygmi); explosive diarrhea; and an increase in blood pressure and pulse rate.

The condition may also occur 2 to 3 hours after eating, and include profuse sweating, anxiety, and fine tremors of the hands and legs. There may be vertigo; exhaustion; palpitations; throbbing headache; faintness; sensation of hunger; glycosuria; and a significant decrease in blood pressure and hypoglycemia. Hypoglycemic symptoms include acute fatigue; restlessness; malaise; irritability; weakness; and, if severe, mental disturbances; delirium; coma, and possibly death. The syndrome is also characterized by prolonged emptying of stomach contents (gastric retention), resulting in abdominal fullness, nausea, and vomiting.

There are no specific tests for postgastrectomy syndrome. Blood tests may be ordered to determine electrolyte and glucose levels in the blood.

Treatment varies with the extent of the original surgery and the severity and number of complications presenting. Treatment may include drug therapy, stress management, and instruction related to avoidance of manifestations of the syndrome. Patients are advised to control the size and frequency of meals; to chew foods thoroughly; to avoid drinking fluids with meals; and to modify intake of dietary nutrients.

Residuals will vary from no residuals to any combination of the signs and symptoms.

• None. 

• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. [38 CR 4.114]

• There are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia and disturbances in nutrition. Consequently, certain coexisting diseases in this area, as indicated in the instruction under the title “Diseases of the Digestive System,” do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding as outlined in 38 CR 4.114.  [38 CFR 4.113]

• There are various postgastrectomy symptoms which may occur following anastomotic operations of the stomach. When present, those occurring during or immediately after eating and known as the “dumping syndrome” are characterized by gastrointestinal complaints and generalized symptoms simulating hypoglycemia; those occurring from 1 to 3 hours after eating usually present definite manifestations of hypoglycemia. [38 CFR 4.111]