bilious vomiting syndrome


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A constellation of symptoms seen in ± 20% of those subjected to gastric surgery—e.g., resection, gastro-enterostomy with total gastric vagotomy, and gastric bypass; most inculpated in ‘dumping’ are pyloric ablation and bypass
Lab Increased glucose—worse with high carbohydrate meals—increased heamatocrit, decreased blood volume related to dehydration, decreased K+
Medical management Decreased carbohydrate intake, smaller meals, pectin—a dietary fiber— acarbose, anticholinergics, L-dopa, opiates
Surgical management 2–5% are medical failures, and require surgical conversion to a Roux-en-Y

bilious vomiting syndrome

duodenogastric reflux of bile; early morning vomiting in dogs, believed to be due to a mild gastritis caused by reflux of bile during sleep.