What to Do for Dumping Syndrome

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Stomach contents empty too quickly into the small intestine resulting in pain, diarrhea and vasomotor symptoms. Photo@ A.D.A.M.

Dumping syndrome may be as unpleasant as it sounds, but there are things that you can do to best manage the condition. This overview will provide you with information regarding what causes dumping syndrome, how it is treated, and how you can best take care of yourself if you find yourself dealing with the symptoms of this disorder.

What Is Dumping Syndrome?

Dumping syndrome, also known as rapid gastric emptying, is a condition in which you experience gastrointestinal or vasomotor symptoms because the food that you eat moves too quickly from your stomach into your small intestine.

  Symptoms are therefore set off when you eat a meal, particularly those with a high glucose (sugar) content.

Dumping syndrome is most often seen in individuals who have had bariatric (weight loss), esophageal or gastric surgery. Estimates of the number of people who experience dumping syndrome following gastric surgery ranges from 25% to 50%. More serious symptoms are seen in approximately 5 to 10 percent of such patients. Severe symptoms are seen more rarely. The type of surgery you have also changes your risk of developing dumping syndrome.

In general, the symptoms of dumping syndrome tend to improve over time. Approximately three quarters of people who undergo gastric bypass will experience symptoms immediately following the procedure, but most people find that their symptoms disappear over the next 15 to 18 months.

Dumping syndrome is broken down into two types: early dumping syndrome and late dumping syndrome.

It is estimated that approximately three quarters of people with dumping syndrome experience the early form, while the other 25% experience the late type. A very small minority of people have both. Early dumping syndrome is characterized by symptoms occurring within 10 to 30 minutes following a meal.

People with late dumping syndrome experience symptoms 2 to 3 hours after eating. The sub-types also manifest with different types of symptoms, with early dumping symptoms being both gastrointestinal and vasomotor, while late dumping symptoms tend to be mostly vasomotor.

Why Does This Happen?

In normal digestion, the stomach empties its contents into the duodenum, the upper part of the small intestine, in a controlled manner in which large food particles are screened out. For some people, changes in the anatomy of the GI tract as a side effect of surgery results in dysfunction of this system. The stomach being smaller, and/or damage to the pylorus, the part of the body that is responsible for acting like a dam, results in large amounts of stomach contents and larger food particles, being released rapidly into the duodenum. This rapid emptying results in pronounced changes in blood glucose level and an increase in certain hormones, which then contribute to cardiovascular symptoms and symptoms associated with hypoglycemia.

Late dumping syndrome results more exclusively from changes in blood glucose and insulin levels. In late dumping syndrome, symptoms are triggered due to too much sugar being released into the small intestine too quickly. This results in a rise in blood glucose level which triggers the pancreas to increase the secretion of insulin. This insulin release then triggers a drop in blood glucose levels resulting in symptoms of hypoglycemia.

Early Dumping Syndrome Symptoms

In early dumping syndrome, symptoms typically start approximately 10 to 30 minutes after eating a meal:

  • Abdominal cramps
  • Nausea
  • Urgent diarrhea
  • Vomiting
  • Blushing of face or skin
  • Feeling light-headed or dizzy
  • Racing heart or irregular heartbeat
  • Sweating
  • Weakness

Late Dumping Syndrome Symptoms

Symptoms of late dumping syndrome generally occur one to three hours after eating a meal:

  • Confusion
  • Dizziness
  • Fainting
  • Fatigue
  • Feeling light-headed or dizzy
  • Flushing of skin
  • Hunger
  • Rapid heartbeat or palpitations
  • Sweating
  • Weakness

Self-Care Do's and Don'ts

As you will see, most of the self-care recommendations for dumping syndrome involve changes in the way you eat, although you also might find that you can reduce feeling light-headed or faint if you lie down, face up, for 30 minutes after meals.

Do:

Don'ts:

  • Don't drink fluids during meals.
  • Don't drink fluids for 30 minutes after meals.
  • Don't eat foods that contain sugar or refined carbohydrates.
  • Don't eat dairy products

Medical Treatment of Dumping Syndrome

If your symptoms persist in spite of making dietary changes, it is imperative that you speak with your doctor. People who have more significant dumping syndrome symptoms are at risk for eating avoidance and nutritional deficiencies. Your doctor will evaluate you and advise you as to the best course of action. If you have late dumping syndrome, your doctor might recommend a fiber supplement to slow down the absorption of glucose and reduce the chance of hypoglycemia. Another option for either type is for your doctor to prescribe one of the medications that are available for treating dumping syndrome.

In extremely severe cases, a surgical procedure might be considered. However, as most cases of dumping syndrome improve over time, surgery would most likely not even be considered for at least one year following the original gastric procedure.

Sources:

National Digestive Diseases Information Clearinghouse "Dumping Syndrome" Accessed March 6,2014.

Tack, J., et.al. "Pathophysiology, diagnosis and management of postoperative dumping syndrome " Nature Reviews Gastroenterology and Hepatology 6:583-590.

Ukleja, A. "Dumping Syndrome: Pathophysiology and Treatment" Nutrition in Clinical Practice 2005 5:517-525.

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