Obesity Surgery

What is dumping syndrome?

Dumping syndrome is a group of signs and symptoms that develops most often in people who have had surgery to remove all or part of their stomach, or in whom much of their stomach has been surgically bypassed to help lose weight. It may occur early or late.

Early dumping

This typically starts during a meal or within 15-30 minutes following a meal. It is thought to be caused by foods which are high in sugar passing too quickly from the stomach pouch into the small intestine. Because the food is very concentrated (dense) it attracts a correspondingly large amount of fluid into the gut causing it to become stretched and painful. Early dumping syndrome symptoms include:

Nausea
Vomiting
Abdominal pain, cramps
Diarrhea
Dizziness, lightheadedness
Bloating, belching
Fatigue
Heart palpitations, rapid heart rate

Late dumping

This typically occurs 1-3 hours after eating. Late dumping syndrome is caused by marked changes in blood sugar levels. When sugar is eaten it is quickly absorbed into the bloodstream triggering a rapid rise in blood sugar levels. The pancreas responds by secreting an equally large amount of insulin to soak up the excess blood sugar. However, sometimes the pancreas produces too much insulin, resulting in a low blood sugar level (hypoglycaemia). Late dumping syndrome symptoms include:

Sweating
Weakness, fatigue
Dizziness, light-headedness
Shakiness
Feelings of anxiety, nervousness
Heart palpitations, rapid heart rate
Fainting
Mental confusion

If you experience late dumping syndrome you need to eat a glucose sweet (anything sweet will do) immediately. Then eat something which is lower in sugar – eg. crackers, wholemeal biscuits, yoghurt etc. The box below provides some general tips to avoid both early and late dumping:

TIPS TO AVOID DUMPING SYNDROME

Avoid problem foods. Everyone tolerates food differently — avoid food that you know cause you problems.
Eat smaller meals. Try taking five or six small meals a day rather than two or three larger ones.
Avoid drinking liquids with your meal. Drink up to 15 minutes before eating and wait at least I hour after your meal before drinking again.
Reduce sugar and simple carbohydrates in your diet. Eat more low-carbohydrate foods. In particular, concentrate on a diet low in simple carbohydrates such as sugar (found in sweets, chocolate, ice-cream, cakes, biscuits etc). Read labels on packaged food before buying, with the goal of not only avoiding foods with sugar in their ingredients list, but also looking for (and staying away from) alternative names for sugar, such as glucose, sucrose, fructose, dextrose, honey and corn syrup. Artificial sweeteners are acceptable alternatives. Consume more protein in your diet, and adopt a high fibre diet with more fruit and vegetables.
Increase pectin intake. Pectin is found in many fruits such as peaches, apples and plums, as well as in some fiber supplements. It can delay the absorption of carbohydrates in the small intestine.
Avoid acidic foods. Tomatoes and citrus fruits are harder for some people to digest.
Use low-fat cooking methods. Prepare meat and other foods by baking or grilling.
Vitamins and Minerals. Make sure you are taking your vitamin and mineral supplements as prescribed.
Lie down after eating. This may slow down the movement of food into your intestines.

Dumping syndrome tends to decrease over several months as the pouch and small intestine learn to work better together. Although dumping is uncomfortable, it is not dangerous