What is Dumping Syndrome?
Dumping syndrome is a collection of gastrointestinal and other symptoms that occur after a person eats. Food and juices moving in a quick and unregulated manner from your stomach into the intestines causes dumping syndrome. The majority of individuals that experience dumping symptoms have had a surgical procedure that removes part of the stomach or bypasses it such as a gastrectomy (removal of the stomach) or gastric bypass Roux-en-Y surgery (which reroutes the digestive system so the stomach is smaller). Dumping syndrome is most likely to occur within the first few weeks following surgery or when you return to your normal diet.
What symptoms can occur as a result of dumping?
Most people experience dumping symptoms immediately following a meal. In some patients symptoms can occur one to three hours after eating. In either case, symptoms can range from mild to severe.
The following symptoms may occur during a meal or 15-30 minutes following a meal.
- Abdominal pain, cramps
- Dizziness, lightheadedness
When symptoms develop 1-3 hours after eating they may include:
- Weakness, fatigue
- Low blood sugar
- Heart palpitations
- Mental confusion
Dietary recommendations for managing dumping syndrome
Individual dietary needs will vary, but below are some guidelines for how to eat to more effectively manage or prevent dumping syndrome.
- Chew well. Food that is chewed well will support a smoother digestive process.
- Eat balanced, smaller meals more often. Strive to eat some healthy carbohydrate, protein, and fats at each meal and snack. Consuming six mini meals every 3-4 hours throughout the day.
- Modify your diet. Carbohydrates are one of three nutrients (along with protein and fat) that help supply the body with energy in the form of sugar and starches. The types of carbohydrates you choose to eat will significantly impact how well you are able to manage or prevent dumping syndrome from occurring. Eating smaller amounts of carbohydrates at each meal is ideal. It is best to use high fiber carbohydrates such as: fruits, veggies and whole grains. These carbohydrates combined with a balance of lean animal protein (such as chicken or fish) and moderate amounts of healthy fats (such as olive oil, nuts and avocados) will help keep your insulin levels more even which can result in improved management of dumping syndrome. Minimize processed sugar (such as cookies, candy, soda) and carbohydrate intake daily to support and maintain a more steady insulin level. Recommended carbohydrates: Larger quantities of vegetables and fruits and smaller amounts of high fiber whole grains such as rice, breads and cereals.
- Avoid fluids with meals. Consume liquids in between meals. Drink liquids half hour before or wait half hour after meals to consume beverages. Try to drink mostly water and keep beverages high in sugar to a minimum.
- Avoid alcohol.
- Avoid dairy if you suffer from lactose intolerance or sensitivity. Certain dairy products contain large amounts of lactose (milk sugar) which could lead to insulin fluctuations signaling more episodes of dumping syndrome. Examples: ice cream, flavored yogurts, and milk. See our lactose intolerance handout for more on this.
- Try to eat protein at each meal and snack. A serving of protein at a main meal is the size of the palm of your hand and at snack half of that.
- Avoid acidic foods. Tomatoes and citrus based fruits can be difficult for some to digest.
- Increase fiber intake. Supplementing additional fiber into your diet such as psyllium, guar gum, and pectin can delay the absorption of carbohydrates in the small intestine.
- Consume adequate vitamins, iron and calcium. Some of these nutrients can become depleted following stomach surgery. Make sure to consult with your healthcare provider about the best way to supplement these in when needed.
- Lie down after eating. This may help slow down the digestive process.
Other Treatment Options
Your healthcare provider may recommend additional medications to help manage your dumping syndrome. These include:
- Acarbose: this delays digestion of carbohydrates and is often used in diabetics with dumping syndrome.
- Octreotide: anti-diarrheal that helps slow the emptying of food into the intestines.
Another treatment option for severe cases may include surgical reconstructive techniques such as reconstructing the pylorus or reversing the gastric bypass surgery. Your health care provider will also evaluate you for other medical conditions that may make you more susceptible to developing dumping syndrome.
Individuals with severe cases of dumping syndrome may experience weight loss and malnutrition. When people experience significant weight loss as the result of ongoing symptoms of rapid dumping they can develop a fear of eating. They may intentionally avoid physical activity and may have a difficult time keeping a job due to the stress of needing to be near a toilet and managing their ongoing symptoms. If you experience severe weight loss and are experiencing difficulty in managing your symptoms please contact your medical provider.
You cannot always prevent dumping syndrome. Dietary adjustments may decrease the severity and prevent recurrences of your symptoms.
The Zone Diet® by Dr. Barry Sears or the South Beach Diet® by Dr. Arthur Agatston are books and diet programs that would support a balanced dietary approach appropriate for managing dumping syndrome.
Additional educational pieces are available at www.mngastro.com and may be helpful in managing or preventing dumping syndrome:
- Guidelines for Healthy Eating
- Insulin Resistance Diet Sample Menu
- Carbohydrate Consumption Guidelines