Dumping syndrome can happen to anyone, but it is more common in people with stomach or esophagus surgery. Also known as rapid gastric emptying, dumping occurs when foods leave the stomach and enter the intestine too quickly. Eating foods high in simple sugars or fat has the highest prevalence of causing dumping.

Patients who underwent bariatric procedures like gastric bypass and gastric sleeve surgery may develop early or late signs and symptoms. Early symptoms, such as abdominal cramps and diarrhea, can occur 10 to 30 minutes after eating. Late symptoms, such as dizziness and fatigue, can appear 1 to 3 hours after eating.

You can control dumping syndrome by eating smaller meals and restricting high-sugar foods. You may need to consult your healthcare provider about medications or an operation in more serious cases.

Dumping Syndrome After Bariatric Surgery - Signs and Symptoms

What is dumping syndrome?

According to Mayo Clinic, dumping syndrome is a phenomenon that occurs when the stomach empties its contents rapidly into the small intestine (duodenum). Partially digested food causes excess fluid in the small bowel, resulting in diarrhea, nausea, stomach cramping, light-headedness, and heart palpitations. When food enters the intestine, the digestive system pulls water from different body parts to dilute the concentration of sugar or fat in your digestive system, creating numerous signs and symptoms. Dumping syndrome can occur while eating and within 30 minutes of your meal or one to three hours after.

Dumping syndrome is a frequent side effect of bariatric procedures that alters the stomach or esophagus’s anatomy. Roux-en-Y gastric bypass and sleeve gastrectomy are some of the most common culprits of dumping syndrome. These side effects occur in about 10-15% of gastric sleeve patients and 25-40% of gastric bypass patients.

Dumping syndrome is more pronounced in gastric bypass patients. In gastric bypass, the stomach is made into a small pouch, and the new pouch is connected directly to the small intestine. So, the ingested food bypasses the pyloric valve and gets dumped directly into the intestine.

What are the signs and symptoms of dumping?

The first symptoms tend to be shared among all patients with dumping syndrome: diarrhea, abdominal cramping, and nausea. Additional side effects include vomiting, stomach cramps, feeling full quickly, dizziness or faintness, rapid heart rate, heart palpitations, and skin flushing. It can also result in excessive hunger, fatigue, sweating, and confusion. Dumping syndrome is classified into two categories; early and late dumping.

Early dumping syndrome

Early signs and symptoms of dumping syndrome can generally occur within 30 minutes of eating and can last an hour. About 75% of people who experience dumping syndrome have early-stage symptoms. There are GI symptoms like belching and cramps and vasomotor symptoms like shock and syncope. Dumping syndrome often comes with diarrhea, but not always.

  • Diarrhea
  • Nausea
  • Bloating
  • Vomiting
  • Cramps
  • Abdominal pain
  • Flushing
  • Dizzy or lightheaded
  • Irregular heartbeat

Early-phase dumping syndrome is usually the result of stretching of the small intestine or hormones released into the small intestine’s bloodstream.

Late dumping syndrome

Late signs of dumping syndrome generally occur 1 to 3 hours after eating or following the early dumping episode. It may feel a lot like having low blood sugar. You may feel shaky, weak, and nauseous. These symptoms can come with or without early phase symptoms.

  • Flushing
  • Sweating
  • Fatigue
  • Weakness
  • Hunger
  • Cold sweats
  • Rapid heartbeat or palpitations
  • Shakiness, dizziness, or passing out
  • Confusion
  • Lack of concentration

Late-phase dumping syndrome symptoms are often because of the rapid rise and fall of blood pressure.

See the video below for a demonstration of dumping syndrome for bariatric patients.

How to get diagnosed and treated

If you are showing any signs of dumping syndrome, consult your doctor. After a series of tests, you should have an official diagnosis.

Dumping syndrome symptoms in gastric bypass patients often overlap with hyperinsulinemic hypoglycemia, excessive insulin production post-meal causing low blood glucose.

To treat it, changing your diet is usually the first step. This includes avoiding foods like sweets, cakes, candies, soda, sweetened juice, pastries, and some bread. You may also be instructed to avoid alcohol and dairy products. You are encouraged to eat fiber and complex carbohydrates and drink plenty of water.

How can I prevent dumping syndrome?

To prevent dumping syndrome, you must avoid eating too much simple sugar and/or too much fat at a meal. You must eat slowly. Each individual will likely tolerate a different amount of simple sugar and/or fat. For this reason, you will need to learn your limits by paying attention to the nutrient content of your meal.

Step 1: Refer to the nutrition facts label of the product. This will likely be a well-tolerated food or beverage if the product has less than 5 grams of sugar.

Step 2: If the product has more than 5 grams of sugar, read its ingredient label. Avoid this product if one of the first five ingredients is an added simple sugar.

Avoid these added simple sugars:

  • Cane sugar
  • Sugar-in-the-Raw
  • Confectioner’s sugar
  • High fructose corn syrup
  • Maple syrup
  • Maltose
  • Molasses
  • Malt
  • Sucrose
  • Table sugar
  • Brown sugar
  • Dextrose

Step 3: Foods and beverages that naturally contain sugar (such as milk, fruit, and starchy vegetables) are typically tolerated; however, some people experience dumping syndrome if the portions are too large. Fruit juice should be limited to 8 ounces per day and diluted 50/50 with water.

How can I avoid dumping syndrome?

You can avoid dumping syndrome by eating smaller snacks throughout the day, not drinking liquids right after eating, and stopping your meals once you feel full. Dumping syndrome is easy to treat in most cases simply by changing your lifestyle, including what, how, and when you eat. Make small changes to see if your symptoms start to subside, consulting a doctor if they don’t get better.

Many patients who have had weight loss surgery assume these symptoms are normal. While dumping syndrome isn’t a serious medical condition in most cases, you should still let your doctor know. Remember what you eat when choosing fiber-rich foods, fruits, and vegetables over sweets and pastries. Not only will it help to prevent dumping syndrome, but it will improve the success of your weight loss surgery.

Dumping Syndrom vs. Gastroparesis?

Gastroparesis is a syndrome that is caused by delayed gastric emptying without the occurrence of any obstruction to the gastric outlet. Symptoms of gastroparesis include;

  • Early satiety
  • Weakness
  • Dizziness
  • Postprandial fullness
  • Nausea
  • Vomiting
  • Abdominal cramping

Dumping Syndrome is Beneficial

Dumping syndrome is not all that bad; it actually helps you succeed in your weight loss journey.  It is a negative reinforcement similar to Pavlov’s dog experiment. The unpleasant feeling you get from the dumping syndrome creates a dislike for sugar and foods with simple carbohydrates. Every time you eat sweets, you experience this uncomfortable sensation. This reminder helps people who have battled obesity all their lives to avoid unhealthy foods and keep a healthy diet.

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