What is Dumping Syndrome? What are the symptoms of dumping syndrome?

 Dumping syndrome is a medical condition in which the stomach empties its contents faster than normal into the first part of the small intestine (duodenum). Dumping syndrome is also known as rapid gastric emptying.

People with dumping syndrome experience symptoms such as nausea and abdominal cramps. These symptoms occur because your small intestine does not absorb nutrients from food that is not properly digested in your stomach. If you have had any type of gastric surgery, such as gastric bypass surgery, you are more likely to have dumping syndrome.

Doctors classify dumping syndrome into two specific types: early dumping syndrome and late dumping syndrome. Each type occurs at different times after eating and causes different symptoms.

There are two types of dumping syndrome. The types depend on when your symptoms start:

Early discharge syndrome. This happens 10 to 30 minutes after eating. About 75% of people with dumping syndrome have this type.

Late discharge syndrome. This happens 1 to 3 hours after eating. About 25 percent of people with dumping syndrome have this type.

Each type of dumping syndrome has different characteristics. Some people have early and late dumping syndrome.

Stages of dumping syndrome

Symptoms of early dumping syndrome can include bloating, diarrhea, nausea, and abdominal pain.

There are two stages of dumping syndrome:

Early emptying syndrome: Symptoms begin 10 to 30 minutes after eating.

Delayed emptying syndrome: Symptoms begin 2 to 3 hours after eating.

According to the National Institutes of Diabetes and Digestive and Kidney Diseases, approximately 75% of people with dumping syndrome experience early dumping syndrome and 25% experience late dumping syndrome. Some people experience two stages.

What are the symptoms of dumping syndrome?

The symptoms of dumping syndrome depend on the type of dumping syndrome you have.

Early discharge syndrome usually occurs within 30 minutes after the end of the meal. If you live with early dumping syndrome, your symptoms may include:

• Nausea
• Vomiting, diarrhea, or abdominal cramps.
• Feels bloated
• Weakness
• Dizziness
• Cold sweats

Symptoms of late emptying syndrome usually appear 2 to 3 hours after a meal. Your characteristics may include:

• Low blood sugar (hypoglycaemia).
• Weakness
• Cold sweats
• Dizziness
• Fast or irregular heartbeat

Causes of dumping syndrome

Generally, when you eat, food passes from your stomach to your intestines for many hours. In the intestines, nutrients are absorbed from food, and digestive juices break down food further.

With dumping syndrome, food moves from the stomach to the intestines very quickly.

Early evacuation syndrome occurs when a large amount of fluid passes from the bloodstream to the intestine due to a sudden influx of food into the intestine. This excess fluid can cause diarrhea and bloating. Your intestine also releases substances that speed up your heart rate and lower your blood pressure. This can lead to symptoms such as a fast heart rate and dizziness.

Late dumping syndrome is caused by an increase in carbohydrates and sugars in the intestines. First, too much sugar can make your blood sugar rise. Your pancreas releases a hormone called insulin to move sugar (glucose) from your blood into your cells. This extra insulin spike makes your blood sugar drop very low. Low blood sugar is called hypoglycemia.

Surgery that makes your abdomen smaller or larger can cause dumping syndrome. After surgery, food moves faster than normal from your stomach to your small intestine. Surgery that affects the way the stomach empties food can also cause this condition.

Types of surgery that can cause dumping syndrome:

Gastrectomy This surgery removes part or all of your stomach.

Gastric bypass (rooks-n-y). This procedure creates a small pouch in your stomach to keep you from overeating. The pouch is attached to your small intestine.

Esophagus. This surgery removes part or all of your esophagus. This can lead to esophageal cancer or stomach damage.

Risk factors

Surgical replacement of your abdomen increases the risk of dumping syndrome. These surgeries are usually done to treat the esophagus, but they are also part of the treatment of stomach cancer, esophageal cancer, and other conditions. These surgeries include:

Gastrectomy, in which part or all of the abdomen is removed.

Gastric bypass surgery (Rooks-N-Y operation), which is done to treat chronic obesity. This surgically creates a stomach pouch smaller than your stomach, which means you cannot eat as much as you used to. It connects the small intestine with this bag in the form of a gastrojejunostomy.

Esophagectomy, in which all or part of the tube between the mouth and the stomach is removed.

Diagnosis

Your Proctologists 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) 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.

Treatment options

You can alleviate the symptoms of dumping syndrome by making a few changes to your diet:

Eat five to six small meals throughout the day instead of three large meals.

Avoid or limit sugary foods like soda, candy, and baked goods.

Get more protein from foods like chicken, fish, peanut butter, and tofu.

Get more fiber in your diet. Switch from simple carbohydrates like white bread and pasta to whole grains like oatmeal and wheat. You can also take fiber supplements. Excess fiber helps sugar and other carbohydrates to be absorbed slowly in the intestines.

Do not drink liquids for 30 minutes before or after a meal.

Chew your food well before swallowing it so you can digest it.

Add pectin or guar gum to thicken your diet. This slows the rate at which food passes from the stomach to the intestines.

Ask your doctor if you need a nutrient. Dumping syndrome affects your body's ability to absorb nutrients from food.

For more severe dumping syndrome, your doctor may prescribe Actriotide (Sandostatin). This medicine alters the way your digestive system works, reducing the emptying of your stomach into the intestines. It also inhibits the release of insulin. You can take this medicine as an injection under the skin, into the muscle of the hip or arm, or through an IV. Some of the side effects of this medicine include changes in blood sugar levels, nausea, pain where you received the injection, and foul-smelling stools.

If none of these treatments help, you may have surgery to reverse the gastric bypass or repair the opening from the stomach to the small intestine (pylorus).

Lifestyle and home remedies

Here are some dietary strategies that can help you maintain good nutrition and reduce your symptoms.

Eat small meals. Try to eat five or six small meals a day instead of three large meals.

Drink plenty of fluids between meals. First, do not drink anything for 30 to 60 minutes before and after meals.

Drink 6 to 8 cups (1.4 to 1.9 liters) of fluids a day. First, limit your fluid intake to 1/2 cup (118 milliliters) with meals. Increase your fluid intake with meals according to your tolerance.

Change your diet. Eat meat, chicken, creamy peanut butter and fish, and complex carbohydrates, oatmeal, and other high-fiber whole grains. Limit foods high in sugar like candy, table sugar, syrups, sodas, and juices.

The natural sugar (lactose) in dairy products can make your symptoms worse. Try small amounts first or remove them if you think they are causing problems. You may want to consult a registered dietitian for more advice on what to eat.

Increase your fiber intake. Psyllium, guar gum, and pectin delay the absorption of carbohydrates in the small intestine from diet or supplements.

Consult your doctor about alcohol consumption.

Complications

Dumping syndrome is a complication of stomach reduction or bypass surgery. Other complications associated with this surgery are:

Problems with the absorption of nutrients.

Anemia, due to lack of vitamin B-12, folic acid, or iron

Osteoporosis, or weak bones, is caused by calcium absorption problems.

Poor absorption of nutrients

Weak bones, also known as osteoporosis, are the result of poor calcium absorption.

Anemia or low red blood cell count, without adequate absorption of vitamins or iron