There are certain risks involved when you have any type of surgery. If you’ve recently had gastric surgery, either to aid in weight loss, or an operation to remove part of your stomach, dumping syndrome is a post-surgery risk. Your stomach may struggle a bit to regulate food movement, and it may move too quickly into your small intestine. Luckily, even severe cases of dumping syndrome are not life-threatening, and it’s a condition you can easily control by practicing healthy food habits. Read on to learn more about dumping syndrome and its causes, when you should seek medical attention, and what foods to eat.
Causes of Dumping Syndrome
Dumping syndrome can occur after any type of stomach, gastric, or esophageal surgery. After you eat, food and gastric juices move from the stomach to the small intestine. However, in a patient that has dumping syndrome, food and juices move too quickly into the small intestine, which can cause discomfort and pain. Any surgery that changes the composition of your stomach can put you at risk for dumping syndrome. These surgeries include:
- Gastric bypass surgery (Roux-en-Y operation). This is an operation used when a patient is morbidly obese. It creates a pouch to make the size of the stomach smaller, so the patient can eat less food in a sitting. This pouch connects to the small intestine (a procedure known as gastrojejunostomy).
- Gastrectomy. This is a procedure where your stomach is removed in part or in full and is performed for a number of different reasons, such as stomach cancer.
- Esophagectomy. This surgery involves the removal of all or part of the esophagus or esophageal tract.
Many of these surgeries are performed to aid in weight loss, but there may be other reasons these surgeries are performed, such as cancer. Other surgeries can contribute to dumping syndrome, but these are the most common culprits.
Dumping Syndrome: Symptoms and Causes of the Early Phase
There are two distinct types of dumping syndrome: early dumping syndrome and late dumping syndrome. Early phase dumping syndrome occurs within 10 to 30 minutes of eating. This is the most common type of dumping syndrome, and it’s estimated that 75 percent of people that have the condition have this type. Each type of dumping syndrome has different symptoms, so it’s wise to let your doctor know when you’re experiencing symptoms and exactly what they are so he or she can guide you into the right dietary changes and treatment program. Early phase dumping syndrome symptoms include:
- Abdominal cramping
- Feeling uncomfortably full
- Rapid heart rate
In essence, you may feel gastrointestinal upset combined with what may feel like an anxiety attack. These are sure signs of early dumping syndrome.
Both types of dumping syndrome involve food moving too quickly into the small intestine (also known as the duodenum), but early and late dumping syndrome have separate causes behind each. In early dumping syndrome, the rapid movement of food into the small intestine also causes fluid to move from the bloodstream to the small intestine also. This is what causes the bloating and diarrhea; and symptoms such as sweating and rapid heart rate are caused by substances released from the small intestine that speed up the heart rate, while at the same time lowering blood pressure.
Dumping Syndrome: Symptoms and Causes of the Late Phase
Late dumping syndrome has different causes than early dumping syndrome, and it typically occurs one to three hours after a meal. While both include rapid gastric emptying, late phase dumping syndrome occurs because of too much sugar and starch in your intestines. In late dumping syndrome, the influx of sugar causes your blood sugar level to rise. However, your pancreas then injects insulin into your cells, and too much insulin causes the opposite effect, which is low blood sugar (also known as hypoglycemia). Because your body’s blood sugar (glucose) level is too low, you now experience dumping syndrome symptoms such as:
- Rapid heart rate
Patients can suffer from both early dumping syndrome and late dumping syndrome; however, early dumping syndrome alone is the most common. Dumping syndrome can also develop years after surgery—it does not always develop right away.
When to Call the Doctor About Dumping Syndrome
Dumping syndrome is mainly controlled by dietary changes. If you suspect you have dumping syndrome, you should let your healthcare provider know so they can refer you to a dietician or can help you create a meal plan to help with symptoms. However, you should call your doctor immediately if you have symptoms of dumping syndrome but have never had gastric surgery, or if your dumping syndrome symptoms persist even after dietary adjustments. You should also call your physician if you’re losing too much weight due to dumping syndrome.
Dumping Syndrome Treatment
Dumping syndrome treatment typically involves dietary changes. Those who have more severe, uncontrollable symptoms may be prescribed a medication known as octreotide. This medicine slows down the gastric emptying of your stomach and blocks the release of insulin. In the most severe cases, surgery may be needed to reverse a gastric bypass operation or to adjust the opening from the stomach to the small intestine, which is known as the pylorus. Generally speaking, however, a change in diet is typically successful.
To avoid dumping syndrome symptoms, most patients will need to:
- Avoid fluids 30 minutes before and after each meal. Fluid can increase rapid gastric emptying.
- Add more protein into the diet. This includes foods such as fish, chicken, tofu, and peanut butter.
- Add more fiber to your diet. Eliminate white bread and pasta and switch to whole wheat, whole grains, and foods such as oatmeal. Taking a fiber supplement is also helpful.
- Eliminate or limit overly sugary foods. These include candy, baked goods, and soda.
- Chew your food completely and slowly. This aids in the process of digestion.
- Eat smaller meals instead of larger ones. Instead of having three large meals a day, opt for six smaller ones, spaced throughout the day.
- Thicken your meals by adding guar gum or pectin. These won’t alter the taste but will thicken your food so that it digests more slowly.
Ask your doctor if you may need a nutritional supplement. A side effect of dumping syndrome involves minerals and vitamins not being properly absorbed into the bloodstream because of the rapid rate of digestion.
Other Gastric Surgery Complications
There are other post-surgery complications to be mindful of if you’ve had gastric or esophageal surgery. Poor nutrient absorption is one of these complications, which can lead to osteoporosis. This is because calcium does not get absorbed into the bloodstream. Ask your doctor if you need to take a calcium supplement. It’s always a good idea to eat calcium-rich or calcium-fortified foods, such as milk and many orange juices.
Gastric surgery can also cause anemia or low blood cell count, which is also a side effect of poor nutrient absorption. Your doctor may want to perform a complete blood count (CBC), just to make sure everything is functioning as it should. If you need more information about dumping syndrome or would like to be seen by a physician, contact Asheville Gastroenterology Associates today. Our doctors are committed to providing individualized and comprehensive healthcare to all of our patients.