What Is Dumping Syndrome?
After stomach reduction or bariatric surgery, it takes time for the body to accept the reorganization of the stomach and intestines applied in these restrictive procedures. During this process, patients must pay attention to their diet and what is eaten. Otherwise, they might encounter extremely serious complications such as dumping syndrome. In this article, we will discuss dumping syndrome in detail so that you will know what it exactly is, what its symptoms are, and how it can be prevented or cured. Dumping syndrome, also called rapid gastric emptying, is one of the most common complications that occur after weight-loss surgical procedures in response to the rapid passage of stomach contents (consumed foods) into the small intestine as a result of regulation and its hyperextension.
As a result, some hormones like serotonin and vasoactive intestinal polypeptide are released. This complication causes discomfort due to hemodynamic and neurovegetative disorders and can have severe impacts on the health-related quality of patients’ lives.
The most destructive damage dumping syndrome creates is trouble in the absorption of nutrients from food, especially calcium absorption, which will result in anemia, weakened bones, or a low amount of red blood cells.
It is extremely important for people to comply with the diet given by their doctor so that they won’t experience this difficulty after the gastro-resection procedure.
Early Dumping Syndrome
Early dumping syndrome occurs within 30 minutes of eating. In this syndrome, the processed food particles the patient consumes pass through the stomach log quickly and unsuccessfully. This rapid passage increases motility in the small intestine as well as the person’s osmotic pressure.
Due to the increased osmotic pressure, blood flow slows down, significant vasodilation occurs, and intercellular function in blood plasma is impaired. The small intestine secretes histamine, serotonin, and quinine to correct these conditions. These secretions cause the intestinal wall of the small intestine to stretch.
Early dumping syndrome usually has some symptoms including vomiting, weakness, abdominal cramping, and nausea.
Late Dumping Syndrome
Late dumping syndrome is the syndrome that usually occurs after consuming food and drink. Here, food (especially overconsumption or unsuitable food) reaches your duodenum quickly after digestion. In this case, your blood sugar starts to rise.
Late symptoms usually appear within 1 to 3 hours or at least 45 minutes after meals. It causes trembling, hunger, concentration disorder, dizziness, and confusion.
Dumping Syndrome Levels
Dumping syndrome can develop in 3 different levels:
Mildly Effective: In this type, the person only experiences increased heart rate and fatigue. It usually disappears within a short time. It does not seriously affect a person’s life.
Moderate: Sharp deterioration in perception, increased heart rate, bloating, intense weakness, irritability, and emotional lability are seen at this level. The effect diminishes when the person lies down.
High level: This type of dumping can occur in a mixed manner as a semato-adreal and a vigo-insular crisis.
Dumping Syndrome Symptoms
The most prominent feature is a feeling of intense weakness for about 15 to 20 minutes during or after eating. Dumping syndrome symptoms may develop as follows:
– The suffering patient experiences a feeling of fullness in their stomach;
– They feel a heat radiating upwards from the stomach;
– Excessive sweating may occur and tremors begin;
– A feeling of general weakness, accompanied by tinnitus, drowsiness, dizziness and trembling of the limbs, even blurred vision occurs;
– Heart rate and breathing rate slows down;
– The person feels a constant urge to urinate;
– The worsening headache may spread.
– In the progression of these symptoms, people may experience conditions such as diarrhea, stomach growling (rumbling), and memory loss.
Sugar, Diarrhea Dumping Syndrome
The main reason for encountering this complication is the consumption of sugary food or things other than your diet. Since the stomach is smaller than before and connects directly to the small intestine, excessive amounts of food or indigestible eatables are absorbed directly. In this case, a rapid increase in blood sugar levels occurs.
Dumping syndrome occurs, especially with diarrhea. Abdominal pain or burning that starts in people progresses to diarrhea.
Dumping Syndrome Hypoglycemia
Hypoglycemia is one of the severe symptoms seen in dumping syndrome. It occurs as an exaggerated response to glucose absorption in the small intestine, especially when the carbohydrate load is rapidly discharged.
Early symptoms of dumping syndrome hypoglycemia may include bloating, abdominal pain, nausea, vomiting, tachycardia, flushing, and hypertension (high blood pressure).
Dumping Syndrome Diagnosis
Based on a study published by the US National Library of Medicine if patients have more than one of the dumping syndrome symptoms (both late and early), the doctor should suspect the presence of this post-weight loss surgery complication.
Oral glucose tolerance test is one of the most effective methods in diagnosing dumping syndrome considering the blood glucose level. Even if the results showed no sign of dumping syndrome, it’d better take continuous glucose monitoring tests for some time after the surgery.
Glycemia measurements can also be used to measure the blood sugar level. Some doctors also prepare questionnaires based on dumping syndrome symptoms, by filling which your doctor will have the necessary information for the right diagnosis.
Moreover, it is vital to constantly check hormone insulin levels in your blood as an excessive amount of it, especially after eating is very dangerous.
So, in case you feel any discomfort, your doctor can easily recognize whether you have this complication or not in order to prescribe the right treatment.
Dumping Syndrome Treatment
In order to prevent or eliminate this common complication, you must change your lifestyle, most importantly your eating habits.
High-sugar food, unnecessary fat, and refined carbonates should be excluded from your diet. Consuming food and drinks together also causes this.
If you find coming up with the right diet difficult, you should consult with a dietitian and determine the most suitable eating plan.
Dumping Syndrome Diet
For people undergoing bariatric surgery, their dietitian sets a special diet that includes particular dietary modifications. It is extremely important not to ignore all the elements in this diet and to follow it to the letter. Dietary content is as follows;
– Avoid larger meals, instead, eat five or six small meals a day. Do not overeat in one go.
– Keep vegetable and meat portions as small as possible.
– Eat a sufficient amount of fiber-rich food because it decreases the pace of food passage from your stomach to the small intestine.
– Limit consumption of milk products to two servings each day.
– Combine protein and fats with fruit or starch. For example, it is much more beneficial for you to eat fruit with cottage cheese.
– Chew your food for a long time. Swallowing it quickly affects your stomach negatively.
– Stop eating when you feel full. You don’t need to fill your stomach completely.
– There should be at least a 45-minute interval between solid food and liquid food. Do not consume these in tandem.
– It may be good for you to lie down and rest for a while after eating.
– Be sure to use fiber supplements such as psyllium, methylcellulose, or benefiber.
– If you absolutely must use a sugar substitute, then use sugar them.
– Drink at least 8 glasses of water. You can mix your water consumption with sugar-free, caffeine-free, non-alcoholic, and non-carbonated beverages.
Dumping Syndrome Medication
Current insights prove that the probability of dumping syndrome varies depending on the type of weight loss surgery. Mini gastric bypass may cause the least complications, while gastric bypass surgery may cause the most severe ones. On average, approximately 1 out of 10 people encounter this challenge after weight loss surgery.
A proficient surgeon will give you all the necessary information before and after the surgery to reduce the risks of these complications. If you take notes while listening to the doctor, you will not forget the details, and you will minimize the risk of dumping syndrome. Also, responsible surgeons pay attention to the follow-up sessions and check everything including blood pressure and glucose in patients.
For the treatment or prevention of this syndrome, people are not mostly advised to use medication. The main treatment for this frequent complication is to make a permanent diet change. However, sometimes osteoid (Sandostatin) medication may be prescribed if the complaints do not improve for a long time.
In addition, in some cases, anti-diarrheal drugs can be used by injection. Thus, the rapid passage of food into the intestines is prevented.
If other medications and diets are not effective, somatostatin analogs are accounted as the last medical method other than surgery.
Generally, surgery is not the first option and most patients should mostly stick to the advised diet, and if necessary use medicines.
However, if you’ve tried them all but still postoperative dumping syndrome is impacting your life, your doctor might suggest surgery as the ultimate treatment.
In most cases, surgery is not needed, but still, some patients have no choice but to undergo another operation.
PMC Labs has introduced a new operative method for curing dumping syndrome. During an accurate analysis, patients were followed up for up to 10 years after the operation. The results showed no death with a low rate of complications. This can be counted as the most effective, yet final step in the treatment process of severe dumping syndrome.
However, it is important to visit a doctor as soon as you feel any signs of dumping syndrome, otherwise, your situation will get worse to the point that an emergency surgery should be operated on you.
Preventing Dumping Syndrome (How to prevent it?)
After gastric surgery, people should consume food suitable for the new stomach and intestine. Therefore, simply by avoiding some specific food, dumping syndrome can be prevented.
You must comply with the diet given by your doctor and do not receive anything other than that. Watch out for these points:
– Do not ingest sugary, acidic, hot drinks should be out of your life.
– Do not exceed the specified portion at each meal.
– Make sure your bariatric surgeon is an expert before the operation.
Dumping Syndrome; Foods to Avoid
The food you must avoid:
– All types of food and beverages containing refined sugar;
– High-carbohydrate meal; and of course simple carbohydrates;
– Dairy products and certain fats;
– Fried food;
– Fatty meats;
– Syrupy foods;
– Foods that have a digestive effect, such as peaches;
– Drinks with extra ingredients such as milkshakes and chocolate milk.
Dumping Syndrome Risk Factors
The main cause of dumping syndrome is gastric resection. Certain actions increase the probability of dumping syndrome:
– Drinking hot milk;
– Simultaneous consumption of liquids and solids;
– Ingesting processed food; the ones with fatty acids in particular;
– Consumption of sugary drinks, especially acidic and refined sugar.
To Sum Up
Remember, healthy individuals who have once undergone bariatric surgery, we’re able to make fundamental changes in their lifestyle. To adapt to your post-surgery life, firstly make sure to choose a sufficient surgeon and dietitian, and second, listen to their advice carefully and take good care of your body and mind.