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 in which food, especially food high in sugar, moves from your stomach into your small bowel too quickly after you eat. Sometimes called rapid gastric emptying, dumping syndrome most often occurs as a result of surgery on your stomach or esophagus.
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 1 to 3 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 within minutes after eating, especially after a meal rich in table sugar (sucrose) or fruit sugar (fructose). They include:
Late dumping syndrome starts 1 to 3 hours after you eat a high-sugar meal. It takes time for signs and symptoms to develop because after you eat 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 health care provider 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, including any stomach surgery or major esophageal surgery, such as removal of the esophagus (esophagectomy). But in rare cases, dumping syndrome can develop without a history of surgery or other obvious causes.
Your stomach is a muscular sac about the size of a small melon that expands when you eat or drink. It holds as much as a gallon (3.8 liters) of food or liquid. Once your stomach breaks down the food, strong muscular contractions known as peristaltic waves push the food toward the pyloric valve. This valve leads to the upper portion of your small intestine, a segment known as the duodenum.
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:
Before gastric bypass, food (see arrows) enters your stomach and passes into the small intestine. After surgery, the amount of food you can eat is reduced due to the smaller stomach pouch. Food is also redirected so that it bypasses most of your stomach and the first section of your small intestine (duodenum). Food flows directly into the middle section of your small intestine (jejunum), limiting the absorption of calories.
Your health care provider 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 dietary changes will ease your symptoms. If not, your health care provider may recommend medications or surgery.
If changes to your diet don't improve symptoms, your health care provider may 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, diarrhea and fatty stools (steatorrhea).
Talk with your doctor about the proper way to self-administer the drug.
If conservative approaches don't help, surgery may be recommended. Depending on your situation, surgical procedures to treat dumping syndrome may include reconstructing the pylorus or surgery to reverse gastric bypass surgery.
Here are some dietary strategies that can help you maintain good nutrition and minimize your symptoms.
Change your diet. Eat more protein, including meat, poultry, creamy peanut butter and fish, and complex carbohydrates such as 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.
Some people use supplements such as pectin and guar gum 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.
If you have signs and symptoms of dumping syndrome, you're likely to first see your family health care provider. 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 health care provider include:
Don't hesitate to ask other questions during your appointment.
Your health care provider is likely to ask you questions, including: