Frequently asked questions about dumping
You might have heard of dumping syndrome or experienced it yourself. It’s an unpleasant experience that happens regularly after weight loss surgery (Gastric Bypass/Gastric Sleeve). What exactly is dumping syndrome? What causes it and what can you do about it? Let’s dig into it by answering the most frequently asked questions.
What is dumping syndrome?
We talk about dumping when food in the stomach is being ‘dumped’ directly into the small intestine. Because the food isn’t digested yet, problems arise. Compare it to an after-dinner dip but much more intense. Although dumping feels uncomfortable, it’s not dangerous or life-threatening. And luckily, in most cases it will reduce or disappear over time.
What causes dumping?
When food is being processed a lot of muscles, nerves and hormones are involved. But after weight loss surgery, the digestive system has changed. That makes it more difficult to absorb and digest nutrition. Also the pyloric is removed after a Gastric Bypass. This is the sphincter between the stomach and the small intestine. Normally the sphincter is closed to keep food in the stomach and digestive juices can do their part. If the food has become fluid, the sphincter opens a few times to let small pieces of food into the small intestine (Duodenum). Without a sphincter, food passes too quickly and you’ll experience dumping. Nutrition rich in carbs (including sugar and starch) can cause it as well.
What are dumping syndrome symptoms?
First of all, there’s a difference between early and late dumping. Early dumping starts 15 to 30 minutes after a meal when too much food flows into the small intestine. Concentrated food pulls moisturize out in the small intestine. Your body reacts by moving fluid circulating in the bloodstream inside the intestines. As result, they get full and bloated. Also, diarrhea, vomiting, nausea, spasm, sweating, dizziness, and abdominal pain are early dumping symptoms.
Late dumping occurs 1 to 3 hours after taking too many carbs (like sugar and starch). When carbs are absorbed the blood sugar level increases. Insulin neutralizes this by decreasing the blood sugar level. If carbs are absorbed faster after surgery, the blood sugar level increases faster as well. However, the production of insulin starts off too slow. The body will keep producing insulin, even when blood sugars are already passed through the bloodstream. The result is that the blood sugar level decreases too much. Compare it to ‘hypo’ (hypoglycemia) which people with diabetes II might experience. Common symptoms of late dumping are sweating, palpitations, shaking, somnolence, hunger, and edginess.
How often does it occur after weight loss surgery?
About 20 to 50% of people with weight loss surgery have dumpings. That means 1 in 5 patients. Mostly it appears after a Gastric Bypass, but also after a Gastric Sleeve. We see it more in women who lost a lot of weight and had diabetes II.
What can you do to prevent dumping?
Dumping is an unpleasant experience and has impact on your daily life. Luckily, most of the time it decreases or disappears. Early dumping around 3 months, late dumping after 12 to 18 months. That’s said, the following tips help you to prevent it:
- Eat 6 small portions spread during the day (3 meals and 3 snacks)
- Keep food and drinks separate. Wait for 30 minutes to give your stomach time to digest
- Eat nutrition rich in fiber and protein. Avoid sugar and fast carbs, spicy or too cold dishes
- Eat and drink mindful and slowly and take small bites and sips
- Sit up straight and try not to speak while eating
- Put your cutlery down after every bite and notice how your stomach feels. Stop eating or drinking when you’re full, experiencing pain or nausea
- Lay down after a meal to help slow down the gastric emptying and stable the blood pressure
- Write down what you eat and which symptoms you have to discover when and which products cause dumping
- Check your (low) blood pressure regularly.
What to eat or not to eat?
Everybody reacts differently on food. If you know what type of products cause a dumping, it’s easier to decrease or avoid them. In general, the next products are (not) recommended:
Eat and drink more
- Protein: eggs, meat, poultry, fish, nuts and seeds, beans and legumes
- Healthy fats: avocado, fish such as salmon and tuna, nuts and nut butter
- Complex carbs: oatmeal, whole grain bread, brown rice and pasta
- Fiber: peas, beans, apples, carrots and broccoli
Eat and drink less
- Sugar: cookies, sweets, breakfast cereals, sugary drinks and desserts
- Dairy: milk, cheese, yogurt and cream (if you have problems taking it)
- Fast carbs: white bread, crackers, crisps and fruit juices
In case these tips do not work, you can take medicines to reduce dumping problems. Always ask your doctor for advice. If you have any questions about dumping syndrome, nutrition or health, our dieticians specialized in weight loss surgery are here to help.