What Is Dumping Syndrome?

Dumping Syndrome

Have you experienced cramps, bloating, diarrhea or vomiting after eating? If you’ve recently undergone weight loss surgery, you’re likely dealing with rapid gastric emptying, otherwise known as dumping syndrome. This is when food gets “dumped” from the stomach into the duodenum, or small intestine, without being properly digested.

Dumping syndrome is fairly common and has been reported in 40% of patients with Roux-en-Y gastric bypass surgery or sleeve gastrectomy. (1)

This article discusses the different types of dumping, when dietary changes may be needed, and dumping syndrome symptoms. 

Dumping Syndrome, Explained

As you might suspect, changing your digestive anatomy through metabolic and bariatric surgery (MBS) can have some repercussions. In this case, undigested food moves through the stomach to the small intestine too quickly, resulting in low blood sugar, light-headedness, and digestive discomfort. 

There are two types of rapid gastric emptying: early dumping syndrome, which occurs within an hour of eating, and late dumping syndrome, which happens 1-3 hours after eating. (1)

Dumping Syndrome Symptoms

The digestive system is complex, and symptoms can manifest in several ways. Here are a few common issues that gastric bypass patients experience.

Early dumping syndrome symptoms include:

• Abdominal cramps or abdominal pain
• Nausea
• Vomiting
• Diarrhea
• Bloating
• Lightheadedness

Late symptoms include:

• Low blood sugar (hypoglycemia)
• Rapid heart rate
• Dizziness
• Sweating
• Low blood pressure
• Heart palpitations

Be sure to keep track of how you feel after eating. While symptoms of early dumping syndrome are experienced first, they can overlap with late dumping syndrome. The time frame of symptoms will help you understand which phase you are experiencing.

How Is Dumping Syndrome Diagnosed?

To get an official diagnosis of dumping syndrome, you can take specific tests, including:

• Oral glucose tolerance test: This test measures your body’s response to sugar (glucose). It is typically used to screen for type 2 diabetes.
• Upper endoscopy: To diagnose dumping syndrome, an upper endoscopy uses a scope with a camera at the end to view the lining of your upper GI tract. It can help find the cause of heartburn, swallowing problems, bleeding, dumping syndrome, etc.
• Upper GI series: This is a procedure where x-rays, fluoroscopy, and barium (chalky liquid) are used to view the upper GI tract.
• Hydrogen breath test: This test requires fasting for 12 hours or more. Drinking a sugary liquid is required, followed by hydrogen breath readings every 15 minutes for an hour.
• Gastric emptying test: This involves eating a meal that contains a small amount of radioactive substance. A camera will then scan the abdomen to locate the substance to follow the rate of gastric emptying after a meal.

How To Handle Dumping Syndrome

There are a couple of ways to treat dumping syndrome symptoms. Making specific dietary changes is the best and easiest way to manage symptoms, though medications and surgery may also help.*

Dietary Changes

Dumping syndrome is often caused by eating high-sugar or high-fat meals. To best support your health after bariatric surgery, your diet should be focused on getting plenty of protein, complex carbohydrates, fiber, and adequate fluid intake.

Here are a few other easy dietary changes you can make to support healthy gastric motility, especially following MBS:*

• Eat a smaller amount of food per sitting. Enjoy 5-6 small meals instead of larger meals.
• Don’t drink fluids with meals. While it’s important to stay hydrated, you’ll want to wait at least 30 minutes after eating to give your food a chance to digest.
• Get more fiber. Fruits, veggies, and oats can help promote a longer transit time to the small intestine. You can also thicken food with guar gum, which is high in soluble fiber and helps slow food transit into the duodenum.
• Prioritize protein. Eating meat, eggs, peanut butter, or other types of protein at each meal can help enhance digestion as well.*
• Chew thoroughly. Eat slowly and chew mindfully. This will prevent too much food from entering your stomach at once. 
• Limit or avoid simple carbohydrates. Sweets and high-fat foods should be off the menu.

Medications

A healthcare provider can prescribe certain medications if dietary changes don't seem to help.

Octreotide is a commonly used injection to help reduce dumping syndrome symptoms. Side effects of this medication include pain at the injection site, diarrhea, weight gain, and steatorrhea. (3)

Another common medication for symptoms of late dumping is acarbose. However, some may experience bloating, diarrhea, and gas with this medication. (3)

Surgery

Surgery is a last resort to treat dumping syndrome after conventional methods fail to work. If dumping syndrome severely affects your quality of life, reconstructive surgery can be considered.

One option would be modifying or reconstructing the part of the stomach that isn’t functioning properly. This process can help delay rapid gastric emptying to limit dumping syndrome.

Another option would be reversing or converting the metabolic and bariatric procedure you underwent to minimize rapid gastric emptying. For example, if you underwent Roux-en-Y gastric bypass, there is an option to convert to Roux-en-Y gastrojejunostomy. This entails further bypassing to connect the jejunum of the small intestine to the stomach after already having a Roux-en-Y gastric bypass procedure.

Surgical decisions are made based on the severity of your symptoms, the metabolic and bariatric procedure you previously had performed, and your health conditions. The first step is to consult with your bariatric provider.

Summary

While dumping syndrome is a risk after metabolic and bariatric surgery (MBS), in most cases, it can be easily managed by eating the right foods, eating smaller meals, and avoiding liquids with meals.

If you feel you have experienced any of the symptoms above, consult with a healthcare professional. Targeting the cause of side effects is step one to supporting a healthy weight loss journey.*

References

Obes Rev. 2017; 18 (68–85)

Revue Medicale Suisse. 2017; Mar; 13 (555)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 2019

This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your bariatric surgeon or another qualified healthcare provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.