September 14, 1984

Evaluation of Postprandial Symptoms-Reply

Author Affiliations

University of Maryland School of Medicine Baltimore

JAMA. 1984;252(10):1281. doi:10.1001/jama.1984.03350100015014

In Reply.—  Patients with postprandial complaints resembling the clinical manifestations of hypoglycemia pose a perplexing diagnostic problem for their physicians. Since symptoms are frequently vague and nonspecific, they may represent manifestations of psychosomatic, psychiatric, or metabolic disorder. It is important to differentiate among the various diagnostic possibilities since the patient will benefit from appropriate therapy.The goal of our study was to develop unbiased and objective diagnostic criteria for the postprandial syndrome. Therefore, we included in the study only patients whose symptom manifestations could be confirmed by an outside observer. The eight patients1 excluded from our study reported only subjective complaints, and there was no assurance that they had the postprandial syndrome. Some of them could have been suffering from the unrelated conditions that create diagnostic confusion.The oral glucose meal has evolved as a standardized, objective procedure to evaluate conditions of patients with postprandial symptoms, since the test