A patient with a surgical injury has a permanently relaxed pyloric sphincter that allows rapid gastric emptying (dumping) into the small intestine. Evaluate the likely immediate and downstream nutritional consequences and the physiologic reasoning behind them.

• A. Rapid dumping causes large volumes of hyperosmolar food to enter the small intestine quickly, drawing fluid into the lumen (causing abdominal discomfort and diarrhea), reduces time for gastric mixing and acid-mediated denaturation which may impair protein processing, and can lead to reactive hypoglycemia from brisk carbohydrate absorption and insulin release — management focuses on slower gastric emptying, dietary modification (small frequent meals, complex carbs), and sometimes medications to slow transit
• B. Permanent pyloric relaxation causes bile to reflux into the stomach which directly increases protein digestion there and therefore causes hyperproteinemia and hypertension
• C. The primary effect is immediate decreased lipid absorption in the colon because the pyloric sphincter normally emulsifies fats, so its loss leads to colon-based fat digestion failure requiring colon resections
• D. Relaxed pyloric sphincter enhances nutrient absorption because more food reaches the ileum where most absorption occurs, so patients typically gain weight rapidly without any GI symptoms

Answer: (A)