What is Dumping Syndrome? Causes, Symptoms & Prevention

Dumping syndrome is a condition that can occur after a person undergoes certain types of stomach surgeries, such as gastric bypass. While unpleasant, it can usually be managed with changes in diet. Once you know how to identify dumping syndrome, you can make the changes necessary to prevent it.

What is Dumping Syndrome?

Dumping syndrome is an unpleasant reaction that can occur after gastric bypass surgery in response to eating or drinking certain foods and beverages. After gastric bypass surgery, the movement of food from the stomach to the small intestine may occur very quickly. This can trigger a cascade of physical reactions, referred to as dumping syndrome. 

Specific food and beverage components are more likely to cause dumping syndrome. Added sugars top the list, followed by high fats and occasionally the sugar naturally occurring in dairy products (lactose).

Some view dumping syndrome as a benefit because it helps them modify behavior and change food choices, resulting in greater weight loss and better long-term maintenance of weight loss.

There are two types of dumping syndrome: early dumping syndrome and late dumping syndrome. Each has its own set of symptoms and possible causes.

Early Dumping Syndrome

Early dumping syndrome is so-called because it happens soon after you eat foods that trigger dumping syndrome.

Possible Causes of Early Dumping Syndrome

With gastric bypass surgery, food movement between the stomach and small intestine is no longer regulated by a sphincter muscle that opens and closes. Instead, the contents of the stomach empty via gravity through a small opening, called a stoma. When foods with high concentrations of added sugar, fat, and, occasionally, lactose enter the small intestine, the body releases water in an attempt to dilute them. In addition, hormones are released that impact blood pressure and speed the transit time through the intestine. 

Symptoms of Early Dumping Syndrome

Symptoms usually start within 60 minutes after eating and last about an hour:

  • Abdominal Cramping
  • Diarrhea
  • Nausea
  • Vomiting
  • Sweating
  • Flushing
  • Light-Headedness
  • Rapid Heart Rate

Late Dumping Syndrome

Late dumping syndrome happens after the period when early dumping syndrome might occur.

Possible Causes of Late Dumping Syndrome

Late dumping syndrome occurs after ingesting foods or beverages with too much added sugar. When the high sugar concentration reaches the small intestine, not only does late dumping syndrome occur but blood sugar is also impacted. The body quickly absorbs the sugar from the intestine causing the blood sugar level to rise. In response to this flood of sugar, the pancreas over-responds and releases too much insulin. 

Symptoms of Late Dumping Syndrome

Late dumping usually happens 1 to 3 hours after eating. The high insulin load causes the blood sugar level to drop quickly, resulting in low blood sugar (hypoglycemia). The symptoms can be mild or severe and last for a short time or remain for several hours:

  • Fatigue
  • Weakness
  • Light-Headedness
  • Flushing
  • Sweating
  • Shakiness
  • Dizziness
  • Fainting
  • Loss Of Concentration
  • Feelings Of Hunger
  • Rapid Heart Rate

Diagnosing Dumping Syndrome

If you have undergone gastric bypass surgery, your doctor may be able to diagnose dumping syndrome from your symptoms without any further tests. However, to assess the severity of your symptoms, you may be asked to answer a questionnaire known as the Dumping Symptom Rating Scale. Doctors may perform additional tests to confirm the diagnosis or eliminate other potential causes of your symptoms.

How to Prevent Dumping Syndrome

A few small modifications to what and how you eat greatly reduces the risk of having dumping syndrome.

Avoiding Added Sugars

Sugars are either naturally occurring or added to the foods and beverages we consume. It’s important to learn the difference because the body handles the sugars differently. Naturally occurring sugars are found in fresh fruits and vegetables and in dairy products. These sugars are typically well-tolerated and do not cause dumping syndrome.

Added sugars are sugars that we add to foods to make them taste sweeter. These are often “hidden” in many highly processed foods, but also found in expected places, such as soft drinks, ice cream, cakes, pies, and cookies. Consuming added sugars will result in dumping syndrome for most who have had gastric bypass surgery. Barix Clinics recommends limiting added sugars to 2 grams or less per serving.

Check the nutrition label on your food package to see how much sugar is in a serving. Then check out the ingredient listing below it. If the product has more than 2 grams of sugar per serving and you see an “added sugar” term within the first five ingredients listed, put it back.

Avoiding High-Fat & Fried Foods

High-fat foods are very concentrated and may empty out of the stomach quickly, resulting in early dumping syndrome.

Limit high-fat foods such as high-fat dairy (including cheese, cream, butter, sour cream, high-fat milk, and high-fat cottage cheese), high-fat meats (including bacon, sausage, bologna, prime rib, ribs, and others), gravy, salad dressing, mayonnaise, nuts (including nut butters), fried foods, most fast foods, and highly processed foods. 

Avoiding Dairy

Lactose, found in dairy products, can cause gas, cramping, bloating, and diarrhea. This intolerance of lactose occurs when the body produces insufficient amounts of the enzyme needed to help digest lactose. Many people experience lactose intolerance throughout their lives. Others find that they become lactose intolerant after bariatric surgery. Sometimes this is temporary. 

Fortunately, small amounts may be tolerated:

  • Add milk to prepared foods, such as casseroles, soups, or baked goods. This may slow down digestion, helping the body to handle the lactose more easily.
  • Try small servings of milk
  • More than half of the lactose is removed when cheese is made—lower-fat options are best
  • Look for cultured milk products, such as yogurt or buttermilk. The friendly bacteria help your body digest lactose.
  • Use lactose-free milk
  • Try soy, rice milk, oat, or almond milk (check for added sugar)
  • Try Lactase-treated milk or caplets to aid in dairy digestion. These products can be found at local grocery stores or pharmacies.
  • Try Digestive Advantage for lactose intolerance to increase the body’s ability to digest lactose

Eating & Drinking Separately

Drinking fluids with food causes food to be forced quickly through the stomach into the small intestine, rather than emptied gently. The body may respond to this concentrated load of nutrients introduced into the small intestine with dumping syndrome. The 5/30 rule is always a good one to follow: stop drinking 5 minutes before eating and don’t resume fluid intake until 30 minutes after finishing a meal or snack.

Small, Protein-Rich Meals

Meal portions should be ¼ to 1 cup in size. Most meals should include a good source of protein. Pair simple carbs (fruits and grains) with protein or fat to limit blood sugar response. Eating six small protein-rich meals levels your blood sugar, which reduces the chance of dumping syndrome. 

Some examples:

  • 1 teaspoon of peanut butter or string cheese with ½ of a small apple for a snack
  • If spaghetti is on the menu, eat a very small (1/4 cup or less) portion of noodles and a larger portion of meat sauce (protein source)
  • Pair cottage cheese with peaches or pineapple
  • Add fruit to protein smoothies (made with milk, low-sugar yogurt, and/or protein powder)

Avoiding Food & Drink at Extreme Temperatures

For some individuals, foods and beverages that are either very hot or very cold can empty into the intestine quickly, causing dumping syndrome. If you experience this, try moderate temperatures to see how your body responds.

How to Treat Dumping Syndrome

Despite your best intentions, if you’re starting to feel the effects of a wrong food choice—what do you do? If you can, lie down and wait for it to pass. Be sure to stay hydrated. Stabilize blood sugar levels with a small serving of complex carbs and protein like nuts.

At Barix, We’re Here to Support You

Our teams are here to guide you through every step of the bariatric surgery process. Our doctors are bariatric surgery specialists who carefully screen each patient. Our nurses and technicians are with you from start to finish and are ready to answer any questions you may have along the way. We have nutritionists on staff to aid you in your new post-surgery diet and minimize your chances of experiencing dumping syndrome.

Call us today at 734-547-4700 or fill out our online form to schedule a consultation. Our team of experts will be happy to answer your questions about bariatric surgery and how our caring staff can help you reduce the chances of dumping syndrome.

About Deb Hart

Deb Hart is a Registered Dietitian Nutritionist. For the last 28 years, she has been helping bariatric surgery patients reach their health and weight goals. She teaches people how to set up a lifestyle that supports a healthy weight. Deb set up her own lifestyle to include lots of long walks with her furry family members, workout classes at her local wellness center, meal prepping, and finding new ways to enjoy foods without added sugar.
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