Dumping Syndrome

Dumping syndrome occurs when the contents of the stomach empty too quickly into the small intestine. The partially digested food draws excess fluid into the small intestine causing nausea, cramping, diarrhea, sweating, faintness, and palpitations. Dumping usually occurs after the consumption of too much simple or refined sugar in people who have had surgery to modify or remove all or part of the stomach.

Prevention

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.

Risk Factors

People who have had surgery to remove or bypass a significant part of the stomach are more likely to develop dumping syndrome. Some types of gastric surgery, such as bariatric surgery, reduce the size of the stomach. As a result, dietary nutrients pass quickly into the small intestine. Other conditions that impair how the stomach stores and empties itself of food, such as nerve damage caused by esophageal surgery, can also cause dumping syndrome.

Causes

Dumping syndrome is caused by problems with the storage of food particles in the stomach and emptying of particles into the duodenum. Early dumping syndrome results from rapid movement of fluid into the intestine following a sudden addition of a large amount of food from the stomach. Late dumping syndrome results from rapid movement of sugar into the intestine, which raises the body’s blood glucose level and causes the pancreas to increase its release of the hormone insulin. The increased release of insulin causes a rapid drop in blood glucose levels, a condition known as hypoglycemia, or low blood sugar.

Symptoms

The symptoms of early and late dumping syndrome are different and vary from person to person.

Early dumping syndrome symptoms may include

• nausea
• vomiting
• abdominal pain and cramping
• diarrhea
• feeling uncomfortably full or bloated after a meal
• sweating
• weakness
• dizziness
• flushing, or blushing of the face or skin
• rapid or irregular heartbeat

The symptoms of late dumping syndrome may include

• hypoglycemia
• sweating
• weakness
• rapid or irregular heartbeat
• flushing
• dizziness

About 75 percent of people with dumping syndrome report symptoms of early dumping syndrome and about 25 percent report symptoms of late dumping syndrome. Some people have symptoms of both types of dumping syndrome.

Diagnosis

Your doctor may use some of the following methods to determine if you have dumping syndrome.

• Medical history and evaluation. Your doctor can often diagnose dumping syndrome by taking a medical history, particularly if you’ve had stomach surgery, and evaluating your signs and symptoms.
• Blood sugar test. Because low blood sugar is sometimes associated with dumping syndrome, your doctor may order a test (oral glucose tolerance test) to measure your blood sugar level at the peak time of your symptoms to help confirm the diagnosis.
• Gastric emptying test. A radioactive material is added to food to measure how quickly food moves through your stomach.

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.

Treatment

Treatment for dumping syndrome includes changes in eating, diet, and nutrition; medication; and, in some cases, surgery. Many people with dumping syndrome have mild symptoms that improve over time with simple dietary changes.

Recovery

The first step to minimizing symptoms of dumping syndrome involves changes in eating, diet, and nutrition, and may include

• eating five or six small meals a day instead of three larger meals
• delaying liquid intake until at least 30 minutes after a meal
• increasing intake of protein, fiber, and complex carbohydrates—found in starchy foods such as oatmeal and rice
• avoiding simple sugars such as table sugar, which can be found in candy, syrup, sodas, and juice beverages
• increasing the thickness of food by adding pectin or guar gum—plant extracts used as thickening agents

Some people find that lying down for 30 minutes after meals also helps reduce symptoms.

Medication

A health care provider may prescribe octreotide acetate (Sandostatin) to treat dumping syndrome symptoms. The medication works by slowing gastric emptying and inhibiting the release of insulin and other GI hormones.

Surgery

A person may need surgery if dumping syndrome is caused by previous gastric surgery or if the condition is not responsive to other treatments. For most people, the type of surgery depends on the type of gastric surgery performed previously. However, surgery to correct dumping syndrome often has unsuccessful results.