BugdocMom

Understanding Dumping Syndrome

91 posts in this topic

Hi all! I have noticed that many folks here on TT are not quite clear on what exactly "dumping syndrome" is. So I thought I'd provide a little info on the topic.

"Dumping" is a medical term describing a condition/complication that can occur in someone who has had gastric surgery (usually associated with the removal of the pyloric valve). Some may confuse lactose intolerance, an irritated pouch, inability to tolerate certain foods, and simply diarrhea or vomiting with "dumping". However, true "dumping" involves a specific suite of symptoms that may or may not include vomiting and/or diarrhea and is usually caused by eating sugar, carbs, and to a lesser extent, fats. Dumping does not occur in pre-gastric bypass folks and only occurs in approximately 30% of post-bypass patients. The condition can usually be controlled by avoiding foods high in sugar, carbs and fats, eating slowly, and not drinking with meals. In other words, following our surgeon's recommended plan:)

I have included info on dumping syndrome from the Mayo Clinic website and a bit from Wikipedia.

"Dumping syndrome is a group of symptoms most likely to develop if you've had surgery to remove all or part of your stomach, or if your stomach has been surgically bypassed to help lose weight. Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small intestine too rapidly.

Most people with dumping syndrome experience symptoms soon after eating. In others, symptoms may occur one to three hours after eating. In either case, symptoms can range from mild to severe and may include:

  • Nausea
  • Vomiting
  • Abdominal pain, cramps
  • Diarrhea
  • Dizziness, lightheadedness
  • Bloating, belching
  • Heart palpitations, rapid heart rate
  • Sweating
  • Weakness, fatigue
  • Shakiness
  • Feelings of anxiety, nervousness
  • Heart palpitations, rapid heart rate
  • Fainting
  • Mental confusion
  • Low blood sugar (hypoglycemia)

In dumping syndrome, food and gastric juices from your stomach move to your small intestine in an unregulated, abnormally fast manner. This accelerated process is most often related to changes in your stomach associated with surgery. For example, when the opening (pylorus) between your stomach and the first portion of the small intestine (duodenum) has been damaged or removed during an operation, dumping syndrome may develop.

Dumping syndrome may occur at least mildly in one-quarter to one-half of people who have had gastric bypass surgery."

"Rapid loading of the small intestine with stomach contents can lead to rapid entry of water into the intestines.

In addition, people with this syndrome often suffer from low blood sugar, or hypoglycemia, because the rapid "dumping" of food triggers the pancreas to release excessive amounts of insulin into the bloodstream. This type of hypoglycemia is referred to as "alimentary hypoglycemia". (Wikipedia)

I hope this helps clear up some of the confusion over the topic and the use of the medical term, "dumping."

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Thank-you for this, very interesting and helpful!

Mrs_Stevens likes this

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Thanks for posting this. I was always curious what is dumping syndrome. :) very helpful info.

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Thank you for this - I just had my 4 month visit with my surgeon. I get really bad shakes if I eat high fat foods and he says this can be dangerous. I have to monitor my sugar levels and eat something bland like fruit or bread to 'come down" as there is the danger of passing out. The best thing however is not to over eat fats!

Thank you again for the article.

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Thank you so much. I'm 7+ mos post-op and wondered why I was getting the palpitations when I ate too much of something (ALWAYS with something I shouldn't have eaten).

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After reading this now I'm worried cause I seem to have loose stool after I eat anything. I thought it was dumping but now I worry I'll never find a food that sits well.

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After reading this now I'm worried cause I seem to have loose stool after I eat anything. I thought it was dumping but now I worry I'll never find a food that sits well.

It hasn't been long since your surgery. Don't worry, there's still hope! Have you tried cutting out dairy for a few days? You may be experiencing some temporary lactose intolerance. It's not uncommon in the first couple of months after surgery. And it often resolves itself so you don't have to avoid dairy forever.

invisiblegirl likes this

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I get a very rapid heart beat, palpitations and shaky. This is if I eat -anything- too quickly (like scarf it down) or if I eat something too high in sugar or even sugar alcohols. The heart racing can last quite a while and tires me out big time. It spikes up past 110 bpm and I have to sit down and rest while it's happening.

I didn't figure out that this was dumping until about 8 months post op. Bananas are the number one food to do it to me.

Like BDM said, it's not ALL the symptoms and it's not only vomiting / diarrhea. Mine is just the heart issues, but it is classic to dumping nonetheless. Watch your bodies, folks, it tells us a lot about what foods are and are not okay to eat anymore.

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When I have sugar free stuff or too much sugar, I get so nauseous, my heart beats fast and hard, my head feels weird - a bit confused, I have to lay down and sleep.

I've had a few weird experiences but not vomited (except when I had stuck food once) and diarrhoea once when I over ate (2 egg omelette) and oh my, the stomach pains were horrific!

Texoma and nellie67 like this

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You should maybe pin this, Genet. Thanks for posting it as well.

Mrs_Stevens likes this

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After reading this now I'm worried cause I seem to have loose stool after I eat anything. I thought it was dumping but now I worry I'll never find a food that sits well.

Oh no you aren't having dumping syndrome you, like myself, just have an incredibly bitchy colon.

teal_peacock and sunshine0614 like this

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sorry for the double post

Edited by PaulaRC

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Is this dumping?

3 hrs after i ate today, I decide it was time to start drinking some water. No problems up to this point. I took a couple of drinks of water and now I am sick. I feel like I need to throw up but can't. I can't swallow my spit either and my nose runs like a fosset. I have to keep spitting the spit out - its almost involuntairy. This is about the 3rd time this has happened to me. It is always several hours after eatting. Only one of the three times did I eat any thing sweet before these episodes but all three times (now that I think about it) i did have small amounts of mashed potatos (approved on my diet right now). Does this mean I can't eat mashed potatos?

rescuesu likes this

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That's what happened to me when I had food stuck but I knew something was stuck by the pressure feeling (and it wasn't 3 hours later).

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Is this dumping?

3 hrs after i ate today, I decide it was time to start drinking some water. No problems up to this point. I took a couple of drinks of water and now I am sick. I feel like I need to throw up but can't. I can't swallow my spit either and my nose runs like a fosset. I have to keep spitting the spit out - its almost involuntairy. This is about the 3rd time this has happened to me. It is always several hours after eatting. Only one of the three times did I eat any thing sweet before these episodes but all three times (now that I think about it) i did have small amounts of mashed potatos (approved on my diet right now). Does this mean I can't eat mashed potatos?

This doesn't sound like dumping. Dumping usually happens pretty quickly after eating. As Sarah mentioned, what you are describing sounds more like what happens when something gets "stuck". It sounds like you tried to drink and it would not go down because the food from earlier was blocking it. This is something you may want to describe to your surgeon. You are in the prime window for a stricture, which is a narrowing of the hole leading from your pouch to your intestines. If that is what is happening, your surgeon will be able to treat it fairly easily.

jenniebean and shortgrl006 like this

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Thanks for posting this.

Can someone pin it at the top? I think it's pretty important :)

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Thanks for posting this. I've been assuming that I don't dump, even though I get the rapid heartbeat and abdominal pain, and sometimes nausea/vomiting. I somehow thought you had to have the cramping and diarrhea- which I don't get. Still relatively mild, but I'm glad to know that the surgery's working.

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Thank You for posting this:)

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I'm so glad you guys have found this helpful

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I am only 3 weeks out so I am learning more daily.

Is there a difference between sugar dumping and fatty food type dumping?

While eating SF Popsicles , right after surgery, I got the sweats and flue like symptoms along with dizziness. Then straight to the bathroom with diarrhea. That happen twice but now I can eat SF Popsicles without problems. This new type of dumping I have had the pleasure of meeting up with is much more vicious! Three nights ago I ordered plain mashed potatoes at a lounge while listening to a friend perform. No sweats were involved but heavy cramping found its way into my bowels, OMG it hurt. Dizziness and flu like symptoms were there as well as diarrhea. It all lasted about an hour and afterwards I was dead to the world; I slept for about an hour as soon as we got into the car. Last night while watching the Superbowl I had a serving of split pea soup. I have had split pea soup in the past without issue; however, I had pureed the soup in the past. Pureed is the only difference, but I dumped bad last night! I didn't sleep but I was totally exhausted after wards for about an hour and then I started getting my strength back! This past weeks two dumping episodes had no sweating issues but a lot of cramping!

So I ask, is there two types of dumping, one for sugar and one for fats?

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Wish i had the answers for you Dogwalker, but i'm just 2 weeks out myself. I think i dumped on Smooth Move Tea a few days ago. I was half way through the cup an i felt panic, my hands were sweating an i was so sick to my stomach :eek:. I had to lay in bed for an hour before those symptoms passed. Funny thing is i had that tea right after surgery an it didn't bother me at all. Now i'm a bit scared to start my cream soups next week an cereals. I had it in my mind dr approved foods wouldn't cause dumping. I guess i was wrong :blink:

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@Dogwalker and ChiefsLady-- The symptoms you describe sound very much like dumping. While many people argue that fats do not cause dumping, it can actually occur when any large particle molecules pass too quickly into the intestines (although it is most often triggered by carbohydrates of some sort, but enough science from me) And the symptoms include sweating, heart pounding, nausea, confusion, fatigue, and sometimes diarrhea and other misery. Many folks tend to dump or experience lactose intolerance in the first few weeks while the new system is healing. Often, as you heal, your body may become less sensitive and your symptoms may go away or require a lot more of the offending food to trigger it. In those early weeks, we sometimes cannot predict what will cause this reaction and it is often not an indication that one will be a regular dumper. If SF popsicles bothered you at first, it was likely the sugar alcohols that were irritating your system. Most people find that sensitivity is reduced later and sugar alcohols no longer cause dumping after a little healing but may still cause bloating, gas and diarrhea. High fat foods usually do not cause "dumping" which is associated with a rapid release of insulin and other hormones and the rapid influx of fluids from your body into your intestines (ok, ok, I'll stop with the science). Most often, what happens with fatty foods is that your new system simply does not tolerate the fats and they are mixed with water and mucous and sent out of your body undigested very quickly... hence the cramping and diarrhea. Miserable, but not technically dumping. But, who cares? It sucks so you want to stay away from fatty foods;)

Rest assured that MOST people experience a reduction in the severity and frequency of their food reactions. But, I say use the early misery and the fear that unhealthy foods will cause dumping or other misery to develop a taste for fresh, simple, low carb/high protein foods that will make your weight loss and maintenance much easier.

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Thanks so much for the valuable info BugDoc  :)

Edited by ChiefsLady

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Just trying to wrap my head around all of this and the science lessons are great!  :)

 

From BugdocMom

"Most often, what happens with fatty foods is that your new system simply does not tolerate the fats and they are mixed with water and mucous and sent out of your body undigested very quickly... hence the cramping and diarrhea."

 

Ok, I eat fat and my new system try's to get it through my new system ASAP, Got that!

Because I am not always in my own kitchen and not totally sure of the ingredients while out and about; is it helpful to withhold from liquids longer then 30 min?

 

Another question is, can drinking to soon after any meal cause this same effect? 

 

From BugdocMom

".... "dumping" which is associated with a rapid release of insulin and other hormones and the rapid influx of fluids from your body into your intestines"

 

So I eat sugar and my old system releases insulin and other hormones into 18in of intestine that has no food to mix in with it? (I say 18in because I understand that the Roux-en-Y was cut in at about 18in.)

 

Thanks BudocMom and sorry for all the questions, its just; dumping sucks and avoiding/understanding it has become quite the challenge. Especially when I am usually out and about when it happens!! :huh: 

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Just trying to wrap my head around all of this and the science lessons are great!  :)

 

 

Ok, I eat fat and my new system try's to get it through my new system ASAP, Got that!

Because I am not always in my own kitchen and not totally sure of the ingredients while out and about; is it helpful to withhold from liquids longer then 30 min?

 

Another question is, can drinking to soon after any meal cause this same effect? 

YES! I dump so easily that I have figured out several "tricks" that help me avoid it. Many of my tricks revolve around liquids... I assume because denser food travels more slowly and lessens the chance of the sugar/carbs going into my system too fast. 1. I ALWAYS eat a handful of nuts or full fat cheese BEFORE I eat anything with carbs that doesn't also have a significant amount of protein. On a bad day, I have literally dumped on green beans:( The fat and protein seem to combine to slow the following food. 2. I wait as long as possible (and NO LESS THAN AN HOUR) before drinking because if I drink while there is still something with carbs still in the pouch and it gets washed through, I'm a goner. 3. If I drink ANYTHING with carbs, it must have ZERO added sugars or fructose AND it must have a lot of protein AND I must drink it slowly. For instance, a cup of milk must be sipped over the span of AT LEAST an hour (I won't go near fruit juice).

So, as you can see, most of my tricks to avoid dumping work to slow the food by avoiding liquid. So, I drink a lot of water between meals. There are very few people who have to be so vigilant, but there ARE some out there. Are you dumping regularly or are you just experiencing a fear based of a couple of early experiences? If you are such a sensitive dumper that you have to try these tricks,it's likely that in the first few months, nothing you do will guarantee you don't dump. But, it will generally get better as you figure out your body's tolerances.

 

So I eat sugar and my old system releases insulin and other hormones into 18in of intestine that has no food to mix in with it? (I say 18in because I understand that the Roux-en-Y was cut in at about 18in.)

 

Thanks BudocMom and sorry for all the questions, its just; dumping sucks and avoiding/understanding it has become quite the challenge. Especially when I am usually out and about when it happens!! :huh: 

A lot if the symptoms of dumping are caused also by the rapid movement of fluid from all over your body to go into your intestines when the food particles go in. That is triggered by the hormones that are released (which includes insulin). I would assume that the fluids also go into the other intestines just because the whole cascade is triggered. But I am honestly not sure if the bypassed intestines are affected. My "gut" says yes;)

I hope that answers your questions... well, as much as I can. If I misunderstood what you were asking, feel free to rephrase and if you have any other questions, throw 'em my way and I'll do my best.

Oh, and especially at your stage, the best way to avoid dumping when you are away from home is to either have your food with you (I carried what I needed for protein drinks, I STILL have protein bars stashed everywhere and have no qualms about pulling one out at a party instead of having the dish that is served) and ONLY eat something you have had before and you are sure has no added sugar (or SA or fat, depending on which make you sick). Like I said, you will figure it out... your pouch will make sure you do;)

dogwalker likes this

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