Dumping Syndrome


Food, especially meals heavy in sugar, might pass from your stomach into your small intestine too rapidly if you have dumping syndrome. Dumping syndrome, also known as fast gastric emptying, most frequently results from stomach or esophageal surgery.

Abdominal pains and diarrhea are among the indications and symptoms that most dumping syndrome sufferers experience 10 to 30 minutes after eating. Some individuals have symptoms 1–3 hours after eating. Some meantime, exhibit both early and late signs.

In general, altering your diet after surgery can help prevent dumping syndrome. Modifications could include reducing high-sugar foods and eating smaller meals. You could require medicine or surgery if your case of dumping syndrome is more severe.

Dumping Syndrome: Causes

Dumping syndrome is characterized by an uncontrolled, abnormally rapid movement of food and gastric secretions from your stomach to your small intestine. The most frequent cause of this is alterations in your stomach brought on by surgery, such as any stomach operations or significant esophageal procedures like esophagus removal (esophagectomy). Yet, dumping syndrome can occasionally appear with no prior history of surgery or other evident reasons.

Dumping Syndrome: Symptoms

Dumping syndrome symptoms typically appear minutes after eating, particularly following a meal high in table sugar (sucrose) or fruit sugar (fructose). They consist of −

  • After eating, feeling bloated or overstuffed

  • Nausea

  • Vomiting

  • Stomach pains

  • Diarrhea

  • Flushing

  • Unsteadiness and faintness

  • Quick heartbeat

One to three hours after a high-sugar meal, late dumping syndrome sets in. Since your body generates huge levels of insulin to absorb the carbohydrates entering your small intestine after eating, it takes time for signs and symptoms to appear. Low blood sugar is the end outcome.

Late dumping syndrome symptoms and signs might include −

  • Sweating

  • Flushing

  • Unsteadiness and faintness

  • Weakness

  • Quick heartbeat

Some individuals exhibit both early and late symptoms. Moreover, dumping syndrome may appear years after surgery.

When to Visit a Doctor?

If you experience any of the following, get in touch with your doctor −

  • Even if you haven't undergone surgery, you could acquire dumping syndrome-related signs and symptoms.

  • Dietary adjustments cannot influence your symptoms.

  • Due to dumping syndrome, you are losing a lot of weight. A trained dietician may be recommended by your doctor to assist you in developing an eating strategy.

Dumping Syndrome: Risk Factors

Dumping syndrome risk is increased if your stomach undergoes surgery. These operations are most frequently done to cure obesity, although they can also be used to treat esophageal cancer, stomach cancer, and other disorders. These operations consist of −

  • Bariatric surgery is used to treat severe obesity, particularly gastric bypass surgery (Roux-en-Y procedure) and sleeve gastrectomy.

  • Having your stomach partially or completely removed (gastrectomy).

  • Esophagectomy, in which the tube connecting the mouth to the stomach is completely or partially removed.

  • Hiatal hernia and gastroesophageal reflux disease (GERD) are both treated with the fundoplication technique.

  • A procedure called a vagotomy is used to treat stomach ulcers.

  • Pyloroplasty is a procedure used to open up the stomach's (pylorus) valve so that food can pass through.

Dumping Syndrome: Diagnosis

The diagnosis of the dumping syndrome is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

The following techniques may be used by your doctor to establish whether you have dumping syndrome −

  • Assessment and medical history. If you've had stomach surgery, especially, your doctor may typically identify dumping syndrome by reviewing your medical history in addition to your signs and symptoms.

  • Test for blood sugar. Because dumping syndrome and low blood sugar can occasionally coexist, your doctor may prescribe an oral glucose tolerance test to check your blood sugar level during the height of your symptoms to aid make the diagnosis.

  • Test for gastric emptying. Food is given a radioactive substance to measure how quickly it passes through your stomach.

Dumping Syndrome: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

By three months, early dumping syndrome is likely to go away on its own. There's a strong probability that making dietary modifications can help you feel better in the interim. If not, your doctor could advise either surgery or medicine.

Your doctor could suggest octreotide if dietary modifications don't help symptoms. An anti-diarrheal medication, which is injected beneath the skin, might delay the passage of food into the intestines. Consequences include nausea, diarrhea, and greasy stools are potential (steatorrhea).

See your doctor for advice on how to properly self-administer the medication.

Surgery may be advised if more conservative measures are unsuccessful. Depending on your circumstances, pylorus reconstruction surgery or surgery to undo gastric bypass surgery may be necessary to address dumping syndrome.

  • Eat smaller portions. Instead of three substantial meals a day, try eating five or six smaller ones.

  • Lay down following a meal. After eating, try resting down for 30 minutes.

  • Most of your fluids should be consumed between meals. First, wait 30 to 60 minutes before and after meals before drinking anything.

  • Consume 1.4 to 1.9 liters (six to eight cups) of fluids each day. Set a 1/2 cup maximum for fluids with meals at the beginning (118 milliliters). As you tolerate it, increase your fluid intake with meals.

  • Modify your diet.

Dumping Syndrome: Prevention

Instead of 3 substantial meals over the day, try to consume 6-8 smaller meals or snacks. Eat more slowly and completely chew your meal. Consume protein-rich food at every meal. Good options include poultry, red meat, fish, eggs, tofu, almonds, milk, yogurt, cheese, and peanut butter.

To assist in reducing gastric motility, it is important to lessen the dumping syndrome's signs and symptoms. To slow the sudden release of the contents into the small intestine, the patient should lie down for 30 minutes.

Conclusion

An interprofessional team composed of nurses, nutritionists, and pharmacists is the most effective in managing dumping syndrome. Being patient and opting for dietary adjustments as the first line of treatment are the keys.

Dietary changes are a helpful treatment for the majority of dumping syndrome patients. At least six times a day is recommended for food distribution. It is best to wait 30 minutes after eating before drinking anything.

Milk products and simple sugars should also be avoided. To make up for the reduced carbohydrate consumption, more calories from protein and fat should be consumed. It has been demonstrated that fiber-rich foods support a longer transit time in the intestine.

The use of drugs and surgery to improve peristalsis is not always successful and may make the symptoms worse. Nevertheless, most patients will benefit from dietary modifications, however, it might take a few weeks or months to see results.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 26-Apr-2023

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