As pre-op gastric bypass weight loss surgery patients we are taught to fear the mysterious dumping syndrome and in most cases we are told that avoiding sugar will prevent the occurrence of dumping syndrome. So it comes as a surprise when after having a malabsorptive gastric surgery we experience symptoms that we think are dumping syndrome, yet sugar has not crossed our lips. Most information discussing dumping syndrome following weight loss surgery focuses on avoiding sugar and suggests that some patients “get” dumping syndrome while others do not get it, almost like it were an optional feature of the surgery. Other misinformation suggests that dumping syndrome goes away after time when patients adjust to surgery and eventually they are able to eat sweets.
Very little clinical research is published to help us understand dumping syndrome beyond personal experience. Combine the lack of reputable information with a plethora of urban legend about dumping syndrome and it is easy to understand the confusion.
Dumping syndrome, also called rapid gastric emptying, is defined by the National Digestive Diseases Information Clearinghouse (NDDIC) as, “a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. It happens when the upper end of the small intestine, the duodenum, expands too quickly due to the presence of hyperosmolar (substances with increased osmolarity) food from the stomach. “Early” dumping begins concurrently or immediately succeeding a meal.” What that means to gastric bypass patients is that food particles are too quickly absorbed by the small intestine because they have gone directly there without the digestive benefits of an intact intestine. The food is literally “dumped” into the small intestine.
To manage this food the pancreas’ releases excessive amounts of insulin into the bloodstream and the body experiences the symptoms of hypoglycemia. Symptoms may begin immediately or anytime within 3 hours of eating and may include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. Symptoms do subside as insulin levels return to normal. Many patients experiencing dumping find comfort in lying down or sipping on fortified water or energy drinks served at room temperature.
The medical community generally agrees the treatment of dumping syndrome is through the avoidance of certain foods that cause it. People who have gastric dumping need to eat small meals that are high in lean protein, low in carbohydrates, avoid simple sugars, and should drink liquids between meals, not with meals. The following are three food groups that should be avoided in the treatment and prevention of dumping syndrome in gastric bypass patients:
Simple Sugars: cookies, cakes, candies, bakery items, ice cream, sweet dairy.
Simple Carbohydrates: chips, crackers, processed cereals, pasta with creamy milk sauces.
High-Fat Cabohydrates: French fries, deep fried food, fast food, grilled food with sweet barbecue sauce, cream based soups and sauces.
A diet of carefully chosen lean protein with low glycemic fresh fruits and vegetables is effective in avoiding dumping syndrome. Ongoing research is beginning to implicate hyperinsulinemic hypoglycemia as the cause of rapid gastric emptying after weight loss surgery but for you and me on the front lines suffering from sweats and chills called dumping, what does that really mean right now? I suggest we become our own personal research scientists and develop a prudent dietary strategy based on current information and personal data that allows us to avoid dumping syndrome and lead a nutritionally balanced life.