Dumping syndrome is a digestive disorder that happens when food is eaten and passes through the stomach too quickly. The food enters the small intestine before it’s been reduced to a liquid form, usually because of a lack of regular intestinal contractions. This causes gas and abdominal distention, sometimes leading to diarrhea or vomiting. It can happen at any time after surgery but is most likely following gastric bypass surgery (laparoscopic sleeve gastrectomy) or gastric banding surgery (Lap-band). This blog post will describe dumping syndrome as it relates to surgery and how to cure it.
What causes dumping syndrome after surgery?
Dumping syndrome is caused by a sudden and dramatic increase in blood sugar levels after eating. This typically happens to people who have had surgery, where the stomach has been reduced in size, or an artificial gastric band has been placed around the stomach. The food isn’t slowly moved down into the small intestine over several hours but instead moves quickly into the small intestine. This is called gastric dumping.
What’s the link between surgery and dumping syndrome?
Gastric bypass surgery and gastric banding surgery are types of surgery that help people lose weight by limiting the amount of food they can eat at one time. They also reduce the body’s absorption of calories. Gastric bypass surgery limits food intake by reducing the size of the stomach and connecting it to the small intestine. The band limits food intake by placing an adjustable band around the top of the stomach.
What is gastric dumping syndrome?
When food passes quickly into the small intestine, it causes the body to produce more insulin than it would normally. This sudden increase in insulin acts like a shot of glucose and results in rapid elevation in blood sugar levels. The body treats this as an emergency and releases several stress hormones to regain normal blood sugar levels. When the causes of dumping syndrome are addressed, it should return to its normal blood sugar levels.
Types of dumping syndrome?
1. Early dumping syndrome.
This is the first type that usually happens after surgery. It usually happens when a person has had a gastric bypass operation and hasn’t had the time to make normal digestive adjustments. The symptoms occur in minutes or hours after eating, and the person will have severe nausea, vomiting, and diarrhea.
2. Late dumping syndrome.
This is a rarer type of dumping syndrome that occurs only in people who have had gastric bypass or banding surgery many years after the procedure. The symptoms occur 1 or 2 hours after eating, and the person will have nausea, abdominal cramping, and diarrhea.
Symptoms of dumping syndrome?
The symptoms of dumping syndrome are:
1. Nausea.
2. Abdominal cramping and bloating.
3. diarrhea.
4. Unexplained fatigue, feeling dizzy, and lightheadedness.
5. Frequent urination.
Prevention of dumping syndrome.
Preventing dumping syndrome is easy if you follow the instructions when your bariatric surgeon gives you post-surgical instructions.
1. Avoid eating foods high in sugar, starch, and fat.
Eating a high-carbohydrate meal causes insulin production quickly and keeps blood sugar high. Eating a high-fat meal has the opposite effect. A high-fat meal causes the body to produce less insulin, which means blood sugar will stay lower longer. When you eat these foods simultaneously as other food, you can experience dumping syndrome, especially if your stomach is still full from the previous meal.
2. Eat slowly.
Make an effort to take small bites and eat slowly. Don’t drink carbonated beverages with meals, as they can stimulate the stomach and cause dumping syndrome.
3. Limit your portions of food.
Portion control is significant when it comes to preventing dumping syndrome. Eating small portions at regular intervals will keep your blood glucose level stable throughout the day.
4. Eat high-fiber foods.
Fiber helps slow down digestion and can delay dumping syndrome by as much as an hour or more. Fiber also aids in making you feel full longer, allowing you to eat fewer calories during a meal.
5. Avoid exercises.
Exercising can make dumping syndrome worse if you have a full stomach, as it may result in the rapid release of insulin. If you exercise on an empty stomach, your body’s response to exercise will be intensified, which could lead to severe cramping or vomiting.
6. Avoid alcohol and caffeinated beverages.
Alcohol and caffeine can cause your blood sugar level to spike quickly and cause dumping syndrome. In addition, alcohol and caffeine are stimulants that may mask other signs of dumping syndrome.
7. Avoid drinking fluids until after meals.
Fluids are not needed with meals because your body does not digest liquids quickly. Waiting to drink until after eating will help you avoid dumping syndrome.
8. Avoid carbonated drinks.
Carbonated beverages can increase the chances of developing dumping syndrome and should be avoided. Carbonation can stimulate the stomach and trigger a dumping episode in some people, even if they don’t have a history of the condition.
9. Avoid certain medications.
Many medications can increase the risk of dumping syndrome, including all drug classes listed here, especially beta-blockers and high blood pressure medications.
10. Don’t smoke.
Smoking will elevate your blood sugar level and increase the risk of dumping syndrome. In addition, smoking is a stimulant that can further mask other symptoms of dumping syndrome.
How is dumping syndrome diagnosed?
Your doctor will ask about your medical history and symptoms, as well as perform a physical exam. They may also want you to have certain tests, including:
1. Blood sugar test.
A fasting blood sugar test is performed on a sample of your blood, usually from the finger. A blood sugar level of less than 70 milligrams per deciliter may be a sign of dumping syndrome.
2. Blood test for electrolytes.
Electrolytes are important minerals in the body that help maintain fluid balance. Blood tests will help your doctor determine if any fluids are being retained. The nurse will also measure electrolyte levels before and after you drink a liquid to ensure no dumping syndrome.
3. Urine test.
Urine testing can show signs of dehydration by evaluating the amount of urine per liter, taking into account how much fluid you’re losing due to vomiting and diarrhea.
4. Electrocardiogram.
Your doctor may also order an electrocardiogram, a small device that records the electrical activity of your heart. It can provide valuable information about the electrical system that controls blood flow in your body and help your doctor determine if dumping syndrome is present.
5. Barium swallow test.
This test involves placing a barium solution on the back of your throat and swallowing it. X-ray imaging is then used to determine if any food material is moving into your stomach.
6. Other tests.
Your doctor may want to perform other tests, such as an upper gastrointestinal series, in which the surgeon passes a thin tube with a camera through your esophagus and into your stomach.
How is dumping syndrome cured?
Medication.
Most cases of dumping syndrome can be controlled with medication, including medications that slow stomach emptying and reduce acid in the stomach, like metoclopramide (Reglan) and proton pump inhibitors.
Bariatric surgery.
There are two options for treating dumping syndrome after surgery: gastric band adjustments or revisional bariatric surgeries. Revisional bariatric surgery is considered the standard treatment for dumping syndrome. Gastric band adjustments are performed only when it’s decided that the original procedure was not performed correctly or that impossible weight loss has been attempted.
Laparoscopic Sleeve Gastrectomy.
Weight loss of nearly 70% can be achieved following this procedure, a type of restrictive surgery. The sleeve gastrectomy restricts the amount of food the stomach can hold to 20 ounces and causes weight loss by restricting the amount of food you can eat and limiting how long it takes for your body to empty the food from your stomach. In most cases, dumping syndrome is relieved for most people after this surgery.
Gastric Bypass.
Weight loss of 62.7% can be achieved following this procedure. It involves creating a small pouch near the top of your stomach, connected to the middle portion of your small intestine, and doesn’t require surgical removal of the pancreas or duodenum. When you eat, food passes through the pouch and empties directly into your small intestine, bypassing most of the stomach and limiting space for food to enter your stomach.
Laparoscopic Roux-en-Y Gastric Bypass.
Weight loss of 62.3% can be achieved following this procedure, a form of restrictive surgery that involves creating a small bypass that bypasses most of the stomach and allows food to enter the small intestine to empty directly into the duodenum.
Sleeve Gastrectomy.
Weight loss of 54.6% can be achieved following this procedure, which involves creating a long, thin doughnut-shaped stomach pouch that completely covers how much you can eat. When food can’t enter the stomach, it’s absorbed directly into the small intestine, bypassing most of the stomach. This operation is generally recommended for people who have failed other weight-loss surgeries and refuse to or are unable to undergo surgery such as gastric bypass surgery or a laparoscopic sleeve gastrectomy.
When should I call my doctor?
Most cases of dumping syndrome are relatively mild, and most people feel better or handle their problems by themselves. You should contact your doctor if you have symptoms for more than a few days that don’t improve, or if you have the following:
1. Severe vomiting that is causing weight loss.
2. Severe diarrhea that is causing weight loss.
3. Frequent dehydration, which causes you to be unusually thirsty and urinate frequently, or your urine contains minimal color or water.
4. Abdominal pain after eating.
In conclusion, before deciding on any surgery, a person must take the time to weigh all their options carefully and make an informed decision. Although gastric sleeve or laparoscopic sleeve gastrectomy surgeries are medically proven to be safe and effective at helping people lose weight, they may not be suitable for every patient. Every person is different, so each surgery should be carefully considered. Keep in mind that there can be risks associated with these surgeries and that not every doctor will perform them. Visiting a surgeon like Dr. Jay Suggs, board-certified by the American Board of Surgery and who understands the procedures and their expectations will help reduce any strain or unwanted stress.
To find out more, visit our main site at https://alabariatrics.com.
references:
https://my.clevelandclinic.org/health/diseases/17835-dumping-syndrome
https://www.ncbi.nlm.nih.gov/books/NBK470542/
https://asmbs.org/patients/bariatric-surgery-procedures