Dumping syndrome is a group of symptoms that are most likely to develop if you’ve had surgery to remove all or part of your stomach, or if your stomach has been surgically bypassed to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach move too rapidly into your small bowel.
Early dumping typically occurs 30-60 minutes after eating and can last up to 60 minutes. Symptoms include sweating, flushing, lightheadedness, tachycardia, palpitations, desire to lie down, upper abdominal fullness, nausea, diarrhea, cramping, and active audible bowels sounds.
Early dumping occurs as a result of rapid emptying of sugars or carbohydrates from the gastric pouch into the small intestine. In response, the body releases large amounts of insulin to absorb the sugars, leading to low levels of sugar in the body (hypoglycemia). This release can affect your blood pressure, heart rate, skin flushing and intestinal transit, leading to a light-headed, rapid heart rate and flushing sensation often accompanied by diarrhea.Early dumping syndrome usually occurs for three to four months after surgery.
Late dumping which usually occurs 1-3 hours after eating. Symptoms are related to reactive hypoglycemia (low blood sugar) which include sweating, shakiness, loss of concentration, hunger, and fainting or passing out.
Late dumping symptoms are related to increased insulin after oral glucose (sugar) with subsequent hypoglycemia (low blood sugar).Symptoms of late dumping can include: sweating, hunger, fatigue, dizziness and lightheadedness, confusion, heart palpitations and rapid heart rate, and even fainting. Some people experience both early and late symptoms. Late dumping syndrome can occur for an entire year post-op, and it may persist for many years. If you experience any of these symptoms, contact your health provider to review your food diary and implement changes to combat this issue.
The most common type of weight loss surgery associated with dumping syndrome is gastric bypass (or Roux-en-Y Gastric Bypass), however some sleeve (Vertical Sleeve Gastrectomy or Sleeve Gastrectomy) patients report symptoms that appear to be dumping syndrome as well. Dumping syndrome is not commonly, if at all, reported in band (Adjustable Gastric Band) or switch (Biliopancreatic Diversion with or without Duodenal Switch) patients. Not all gastric bypass or sleeve patients will experience dumping syndrome though. Talk with your surgeon if you’re considering weight loss surgery about which surgery is right for you and your chances of developing dumping syndrome with each procedure.
If you have signs and symptoms of dumping syndrome, you’re most likely to see your primary care physician, surgeon and/or dietitian at the bariatric center. Most cases of dumping syndrome improve as you learn to eat in a manner that should prevent the condition from occurring and as the digestive system adjusts. There’s a good chance that changing your diet will resolve your symptoms. If it doesn't, your doctor may advise medications and/or surgery to address the problem. Here are some dietary treatment strategies that your doctor or dietitian may recommend and that you can try on your own. They can help maintain good nutrition and minimize your symptoms.
Drink liquids only between meals. Avoid liquids a half-hour before eating and a half-hour after eating. Some bariatric programs will recommend this or no fluids with meals or 30 minutes after the meal. Talk to your surgeon and/or dietitian to learn how they would like to you to consume fluids in regards to mealtime.
Consume more protein-rich foods such as red meat, pork, fish, and chicken. Include some fat (healthy fats preferably) with your meal. For example olive oil, which adds calories, may help dumping symptoms. Limit your intake of foods and drinks with high sugar content. Milk contains a natural sugar, lactose, which may cause dumping syndrome depending on the person. A small serving (½ cup) of milk, cheese, or yogurt is tolerable to most people. Consume more foods low in carbohydrates, such as grains, starchy vegetables and fruits. Avoid foods with simple sugars, including glucose, sucrose, fructose, dextrose, honey and corn syrup. It may help to see a registered dietitian to learn which eating plan strategies are right for you in your progression following bariatric surgery.
Even with dietary changes, you may continue to experience symptoms associated with dumping syndrome. It’s important to manage those dumping syndrome symptoms so you stay well nourished and don’t lose too much weight too fast.
Talk to your health care provider about any symptoms you have experienced and what else you can do so you continue to CELEBRATE your weight loss success.
Please Note: Dairy products such as milk, cottage cheese, ice cream, and pudding may cause diarrhea in some people after surgery. You may need to avoid milk products at first and then try them in small amounts as you advance your diet. Please remember that this article is not intended to provide individual medical advice. Every bariatric patient is different and it’s important to seek medical advice from your surgeon, dietitian, and nurses at your bariatric hospital or clinic.
By Nadea Minet MS, RD, LD
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