傾食症候群(dumping syndrome, DS)主要的成因為經歷過各式胃部切除、減重手術後，因胃排空加速，導致未消化完整的高滲透性食糜過快進入小腸，進而引發腹痛、腹脹、噁心等症狀。對於胃部術後病人，發生率約20-50%。治療包括飲食調整以少量多餐、避免高糖、攝取高纖維及高蛋白質飲食為主，如若症狀持續可以考慮以藥物緩解症狀。個案為75歲男性，病史為消化性潰瘍穿孔及貧血，因腹痛腹脹急診入院，經病史詢問及檢查後診斷為DS引起的腹痛。病人19歲時因消化性潰瘍穿孔接受胃部次全切除術及Roux-en-Y吻合術，術後長期貧血及體重過低，BMI為16.6，屬高風險營養不良。住院期間採症狀藥物控制、鼻胃管減壓、靜脈營養支持，並由營養師設計每日1,600大卡及58克蛋白質的飲食計劃。經飲食漸進調整，病人逐步恢復進食能力，改善腸脹氣與不適，出院前每日可進食200-250克稀飯或軟質食物，搭配營養補充品。病人症狀穩定後出院，並持續遵守飲食原則以減少復發風險。
(台灣家醫誌2025; 35: 132-141) DOI: 10.53106/168232812025063502006
 
關鍵詞：胃切除、傾食症候群、腸阻塞

---

¹中山醫學大學附設醫院家庭暨社區醫學部
²中山醫學大學附設醫院營養科
³中山醫學大學附設醫院老年醫學科
⁴中山醫學大學營養系
受理日期：114年2月12日 修改日期：114年3月10日 同意刊登：114年3月26日
^*通訊作者：蕭鈺瑾 通訊地址：臺中市南區建國北路一段110號 E-mail: cshn070@csh.org.tw
 

---

---

Dumping Syndrome in Gastrectomized Elderly Patients
 
Yi-Lin Xin¹, Yu-Chin Hsiao^2*, Hui-Wen Chang^1,3, Chia-Yang Lin^1,3,and Hsing-Chun Lin^2,4
 

Dumping Syndrome (DS) is a condition that occurs after gastric or bariatric surgery, whereaccelerated gastric emptying causes undigested hyperosmolar chyme to rapidly enter the smallintestine, leading to symptoms such as abdominal pain, bloating, nausea and vomiting. Its prevalencein patients undergoing gastric surgery can be as high as 20-50%. Treatments include dietarymodification with small, frequent meals, avoidance of high-sugar foods, and adherence to high-fiberand high-protein diets; if symptoms persist after dietary modification, symptomatic medication maybe considered. The case involves a 75-year-old male with past medical history of perforated pepticulcer and anemia, admitted to the emergency department due to abdominal pain and bloating. Hewas diagnosed with DS-related abdominal pain based on history and clinical evaluation. At age 19,the patient underwent subtotal gastrectomy with Roux-en-Y anastomosis due to perforated pepticulcer, resulting in chronic anemia and underweight with a BMI of 16.6, indicating a highmalnutrition risk. During hospitalization, he was treated with symptomatic medication, nasogastricdecompression, intravenous nutritional support, and a dietitian-designed meal plan providing 1,600calories and 58 grams of protein daily. Through gradual dietary adjustments, the patient regainedeating ability and experienced improvement of intestinal symptoms. Prior to discharge, he couldconsume 200-250 grams of porridge daily, supplemented with nutritional drinks. The patient wasdischarged in stable condition and continued to maintain dietary modifications to prevent recurrence.
(Taiwan J Fam Med 2025; 35: 132-141) DOI: 10.53106/168232812025063502006
 
Key words: dumping syndrome, gastrectomy, ileu
 

---

¹Department of Family and Community Medicine, Chung Shan Medical University Hospital
²Department of Nutrition, Chung Shan Medical University hospital
³Department of Geriatrics, Chung Shan Medical University Hospital, Taichung
⁴Department of Nutrition, Chung Shan Medical University
Received: February 12, 2025; Revised: March 10, 2025; Accepted: March 26, 2025.
^*Corresponding author