What is dumping syndrome?
Dumping syndrome (also called rapid gastric emptying) is a health condition that happens when the eaten food is moving from the stomach to the duodenum (the first part of the small intestine) too quickly.
People who experience gastric dumping syndrome generally belong to one of 2 groups:
- they have undergone a weight loss surgery (e.g. sleeve gastrectomy or gastric bypass)
- they have undergone esophageal surgery.
There are two types of dumping syndrome, an early one and late dumping syndrome
There are two types of stomach dumping syndrome. The most frequent type is early dumping syndrome. It occurs within 30 minutes after eating (usually 10-30 minutes) and happens to 75% of people with digestive dumping syndrome. The boost for this condition is a fast and dynamic movement of fluid followed by food (especially sweet/sugary food) from the stomach into the intestine. The second type is a late dumping syndrome, which happens about 1-3 hours after eating. About 25% of people experience this type of dumping syndrome. It happens when too much sugar moves towards the intestine raising the blood glucose and increasing insulin release, and eventually a rapid insulin drop. There are also people suffering from both early and late types of dumping syndrome.
Dumping syndrome causes
The main cause of dumping syndrome is merely the food and liquid that moves from the stomach to the small intestine too quickly. The digestive tract produces and manages the hormones which control the work of a whole digestive system. When the food movement is too fast, more hormones are released, and additionally, there is also liquid that moves with the food to the duodenal – and these are excessive hormones and fluid that are responsible for early dumping syndrome. The mentioned hormones make the pancreas produce highly too much insulin. Such a rapid release of insulin results in a rapid glucose drop in 1-3 hours – and it is responsible for late dumping syndrome.
The dumping syndrome causes are mainly connected to the surgeries that influence the digestive system (e.g. it is common to have dumping syndrome after bariatric surgery or dumping syndrome after gastrectomy).
The most common procedures causing postoperative dumping syndrome are:
- bariatric surgeries (especially gastric bypass and gastric sleeve)
- gastrectomy
- esophagectomy
- vagotomy
- fundoplication.
The non-surgery reasons for dumping syndrome include:
- duodenal ulcers
- insufficiency of pancreatic exocrine causing digestive problems
- diabetes (particularly type 2 diabetes)
- Zollinger-Ellison syndrome.
There are also people with dumping syndrome who have not experienced any of the mentioned health conditions and it is not known what the reason is. There are still numerous studies performed on the dumping syndrome causes, so in the future, we will probably extend our knowledge in this field.
Dumping syndrome symptoms
Dumping syndrome symptoms differ for early and late types of this condition.
Early dumping syndrome symptoms appear about 10-30 minutes after the meal and include:
- vomiting
- nausea
- abdominal cramping
- dizziness
- diarrhea
- weakness
- cold sweats
- feeling bloated.
Late dumping syndrome symptoms appear 2-3 hours after finishing the meal and include:
- weakness
- hypoglycemia (low blood sugar level)
- dizziness
- cold sweats
- skin flushing
- hunger
- irregular or/and rapid heartbeat.
How long does dumping syndrome last
If patient suspects that may have dumping syndrome should contact the doctor straight away as not diagnosed and treated it may last for years and get more and more dangerous for health
Dumping syndrome is a condition that may appear either right after eating a meal or a few hours later (the former is called early dumping syndrome and the latter is a late dumping syndrome). Also, the intensity of symptoms of this condition varies from person to person. One may suffer unbearable vomiting, diarrhea, and cramping while others feel slightly weak and have mild nausea – however, it is very important to observe the body and note all the symptoms, even these mild ones. It is also hard to determine how long dumping syndrome lasts as sometimes it may last 30 minutes and the other time lasts throughout a day and gets intensified after each meal. Usually, for bariatric patients, a dumping syndrome disappears once the stomach recovers and adapts after the weight loss surgery. Early dumping syndrome usually occurs within months after surgery while late dumping syndrome occurs within a year after the surgery. Not diagnosed and treated, dumping syndrome may last for years and get more and more dangerous for health (especially late dumping syndrome tend to persist for a long time), so we advise everyone experiencing the symptoms related to dumping syndrome to contact the doctor to check whether nothing worrying happens.
Dumping syndrome treatment
Dumping syndrome is a condition that should be medically recognized to be treated. There are several ways for determining it. Firstly, people who experience the symptoms related to early and late dumping syndromes should discuss them with the doctor who will carry out the further examination. Of course, patients who have undergone the surgeries that may cause dumping syndrome are informed about the possibility of such a condition and are explained what they need to pay attention to. The doctor starts with analysing the medical history of a person (including family history, symptoms, previous surgeries and procedures), then the oral glucose tolerance test (low blood sugar level may indicate a dumping syndrome) and gastric emptying test (the doctor monitors the movement of a special material through the digestive system) is performed. Once diagnosed, the doctor starts the treatment of dumping syndrome. The basic treatment of dumping syndrome is a diet. Only if it does not bring the effects, the doctor may recommend dumping syndrome medications or alternatively the surgery.
Diet guidelines that help treat dumping syndrome include:
- eating at least 5-6 tiny meals a day instead of 3 main meals and 2 snacks
- eating only till the feeling of being full
- thorough chewing of each bite
- avoid drinking 30 minutes before and after the meal
- drinking at least 1,5 litres of water a day
- taking a 20-30 minute rest after meals
- adding high-fiber food to the diet (e.g. oatmeal, beans, vegetables, whole wheat bread)
- avoid sugary food and drinks
- resign from white rice, white bread or pasta
- eat products rich in proteins, e.g. fish, tofu, lean meats
- try avoiding products containing lactose.
If the diet does not reduce dumping syndrome symptoms, a doctor would probably prescribe the octreotide injection (the anti-diarrheal drug) – such an injection slows down the pace of food movement into the small intestine and prevents insulin release. Surgery is just a last resort, but sometimes it is inevitable to perform it to relieve the patient.
Dumping syndrome diet
The important aspect of gastric dumping syndrome diet is to avoid extremely hot and cold food
Dumping syndrome diet should be composed of at least 5-6 small meals (for the most part, 8 meals a day are suggested). What people should pay attention to is their body reaction to the food types they eat. Food tolerance differs among people so everyone should avoid the products and meals that cause digestive problems. The other important aspect of gastric dumping syndrome diet is to avoid extremely hot and cold food. The best diet for dumping syndrome or anti dumping syndrome diet does not exist, but we present some universal guidelines for the food that should be chosen by those who follow a diet syndrome diet plan.
PRODUCT | SERVING | FOOD TO CHOOSE | FOOD TO AVOID |
|---|---|---|---|
| CEREALS, RICE, BREAD, PASTA | between 6 and 11 servings a day | bread, rolls, bagels, rice, pasta, crackers, soups, potatoes | sweetened cereals, wheat rolls, pancakes, doughnuts |
| VEGETALBES | between 3 and 5 servings a day | all vegetables are allowed | only vegetables that are not tolerated by an individual |
| FRUIT | between 2 and 3 servings a day | all fresh fruit, unsweetened frozen or canned fruit, juice (containing 100% pure fruit) | sweetened frozen or canned fruit, fruit in syrup, candied fruit, sweetened juices, drinks or punch |
| MEAT, POLUTRY, FISH, EGGS, CHEESE, BEANS, PEAS | between 2 and 3 servings a day | all types of meat, poultry and fish, eggs, dried beans, legumes, peanut butter | only products badly tolerated by an individual, reduced amount of eggs and cheese |
| DIARY PRODUCTS *Some patients are advised to try a lactose free diet | maximum 2 servings a day | plain yogurt, skimmed milk | sweetened yogurt, chocolate milk, milkshakes |
| SNACK AND SWEETS | as rare as possible | sugar free pudding, gelatine or candies, substitutes for sugar | sugar, sorbitol, xylitol, mannitol, candies, chocolate, cookies, cakes, sweet desserts, ice creams, sherbets |
| FATS, DRINKS, CONDIMENTS | limited | butter, cream, margarine, oil, salt, spices, herbs, beverages without sugar (coffee, tea, soda) | sweetened drinks, honey, jelly, syrups, pickles, any other badly tolerated products. |
How to prevent dumping syndrome?
People wondering how to prevent dumping syndrome or trying to determine the management of dumping syndrome should realize that for the most part, it is a diet that may prevent dumping syndrome.
The main aspects are:
- changing how people eat: it includes implementing 6-8 small meals, drinking only between the meals (not during or just before/after the meal), lying down for 20 minutes after eating
- changing what people eat: eating more fiber, proteins and fat and less carbohydrates (especially simple sugars), trying a lactose-free diet, adding a guar gum or pectin to the diet.
People having a weight loss surgery are highly prone to suffer from dumping syndrome even years after the surgery, so keeping a healthy diet is important not only until the desired weight is achieved but for the rest of their lives.
Dumping syndrome summary
Dumping syndrome is a condition of too fast gastric emptying that happens usually after surgical procedures affecting the stomach (e.g. gastric bypass, gastric sleeve, esophageal surgeries). The usual symptoms are diarrhea, nausea, vomiting, feelings of weakness and dizziness, fast and irregular heartbeat, and cold sweats – if people after the mentioned procedures experience such symptoms, they should immediately discuss it with the doctor because untreated dumping syndrome may do much harm to their health. The 3 ways of treating dumping syndrome are a healthy diet, medications and surgery. For the vast majority of patients, just a proper diet is enough to get rid of dumping syndrome, so we strongly advocate a healthy, balanced diet just to prevent this gastric problem.
Sources
Admin, No Stomach For Cancer. “After Diagnosis.” No Stomach For Cancer, www.nostomachforcancer.org/about/life-without-a-stomach/special-concerns/dumping-syndrome.
“Dumping Syndrome: Symptoms, Causes, and Phases.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/320479.
“Eating, Diet, & Nutrition for Dumping Syndrome.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Jan. 2019, www.niddk.nih.gov/health-information/digestive-diseases/dumping-syndrome/eating-diet-nutrition.
Reviewed by Digestive Disorders March 25, 2016. “Dumping Syndrome Diet Plan.” UPMC HealthBeat, 30 Apr. 2020, share.upmc.com/2016/03/dumping-syndrome-diet-plan/.
“What Is Dumping, and Why Am I Experiencing It?” Obesity Action Coalition, www.obesityaction.org/community/article-library/what-is-dumping-and-why-am-i-experiencing-it/.
