People who have had stomach or weight-loss surgery can develop dumping syndrome, which causes cramping, diarrhea and, sometimes, low blood sugar.
Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. The condition can also develop in people who have had esophageal surgery. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.
Most people with dumping syndrome develop signs and symptoms, such as abdominal cramps and diarrhea, 10 to 30 minutes after eating. Other people have symptoms one to three hours after eating, and still others have both early and late symptoms.
Generally, you can help prevent dumping syndrome by changing your diet after surgery. Changes might include eating smaller meals and limiting high-sugar foods. In more-serious cases of dumping syndrome, you may need medications or surgery.
Signs and symptoms of dumping syndrome generally occur right after eating, especially after a meal rich in table sugar (sucrose) or fruit sugar (fructose). Signs and symptoms might include:
Late dumping syndrome starts one to three hours after you eat a high-sugar meal. The signs and symptoms develop that long after you eat because your body releases large amounts of insulin to absorb the sugars entering your small intestine. The result is low blood sugar.
Signs and symptoms of late dumping syndrome can include:
Some people have both early and late signs and symptoms. And dumping syndrome can develop years after surgery.
Contact your doctor if any of the following apply to you.
In dumping syndrome, food and gastric juices from your stomach move to your small intestine in an uncontrolled, abnormally fast manner. This is most often related to changes in your stomach associated with surgery.
Dumping syndrome can occur after any stomach surgery or major esophageal surgery, such as removal of the esophagus (esophagectomy).
Surgery that alters your stomach can increase your risk of dumping syndrome. These surgeries are most commonly performed to treat obesity, but are also part of treatment for stomach cancer, esophageal cancer and other conditions. These surgeries include:
Your doctor may use some of the following methods to determine if you have dumping syndrome.
Early dumping syndrome is likely to resolve on its own within three months. In the meantime, there's a good chance that diet changes will ease your symptoms. If not, your doctor may recommend medications or surgery.
For people with severe signs and symptoms unrelieved by dietary changes, doctors sometimes prescribe octreotide (Sandostatin). This anti-diarrheal drug, administered by injection under your skin, can slow the emptying of food into the intestine. Possible side effects include nausea, vomiting and stomach upset.
Talk with your doctor about the proper way to self-administer the drug.
Doctors use a number of surgical procedures to treat people who have dumping syndrome that doesn't respond to more conservative approaches. Most of these operations are reconstructive techniques, such as reconstructing the pylorus, or they're intended to reverse gastric bypass surgery.
Some people use supplements such as pectin, guar gum, black psyllium and blond psyllium to thicken the digestive contents and slow its progress through the intestines. If you decide to try a supplement, discuss it with your doctor to learn about potential side effects or interactions with other medications you're taking.
Here are some dietary strategies that can help you maintain good nutrition and minimize your symptoms.
Change your diet. Eat more protein — meat, poultry, creamy peanut butter and fish — and complex carbohydrates — oatmeal and other whole-grain foods high in fiber. Limit high-sugar foods, such as candy, table sugar, syrup, sodas and juices.
The natural sugar in dairy products (lactose) might worsen your symptoms. Try small amounts at first, or eliminate them if you think they're causing problems. You might want to see a registered dietitian for more advice about what to eat.
If you have signs and symptoms of dumping syndrome, you're likely to first see your family doctor or a general practitioner. You may then be referred to a doctor who specializes in treating digestive system disorders (gastroenterologist).
Here's some information to help you get ready for your appointment.
For dumping syndrome, some basic questions to ask your doctor include:
Don't hesitate to ask other questions during your appointment.
Your doctor is likely to ask you questions, including:
December 22nd, 2020