Patient education: Dumping syndrome (The Basics)

What is dumping syndrome? — Dumping syndrome is when food moves too quickly from the stomach to the small intestine (figure 1). It most often happens to people who have had stomach surgery. Other times, surgery on the esophagus (the tube that carries food from the mouth to the stomach) can cause it.

Surgeries that can cause dumping syndrome include:

●Gastric bypass – This is a type of weight loss (or "bariatric") surgery.

●Gastrectomy – This is when all or part of the stomach is removed.

●Esophagectomy – This is when all or part of the esophagus is removed.

●Pyloroplasty – This is surgery to widen the valve the connects the stomach to the small intestine.

●Surgery to treat problems such as stomach ulcers, gastroesophageal reflux disease ("GERD"), or hiatal hernia

Rarely, dumping syndrome can happen to people who have not had any of these surgeries.

What are the symptoms of dumping syndrome? — Most people who have dumping syndrome have "early" dumping syndrome. This means that symptoms happen about 15 to 30 minutes after eating. They include:

●Nausea and vomiting

●Feeling too full or bloated after eating

●Belly cramping

●Diarrhea

●Feeling dizzy or lightheaded

●Very fast heartbeat

●Flushing – This is when your face, neck, or upper chest feel hot. Your skin might also look red.

●Headache

●Sweating

●Hearing rumbling noises from your belly area

For people with "late" dumping syndrome, their symptoms happen several hours after eating. Symptoms can include:

●Sweating

●Flushing

●Feeling dizzy or lightheaded

●Weakness

●Very fast heartbeat

Will I need tests? — Maybe. Your doctor will start by talking to you about your symptoms and doing an exam. Tests can include:

●Mixed meal test – This involves eating food and then having blood samples taken. Your doctor or nurse will tell you what to eat for this test. Your blood will be tested.

●Gastric emptying test – This is a type of imaging test. It shows how long it takes food to leave your stomach. For the test, you eat a light meal or drink something. The food or drink has a very small amount of a radioactive substance, called a "tracer." Then, a device called a "gamma camera" is used to create images of where the tracer is in the body.

●Upper endoscopy – This is a procedure that lets a doctor look at the esophagus, stomach, and small intestine. It is done using a thin, flexible tube with a camera on the end.

How is dumping syndrome treated? — Early dumping syndrome usually gets better on its own within 3 months. In the meantime, changing the way you eat can help with symptoms. More information about this is below.

If your symptoms are not getting better, your doctor might prescribe medicine to prevent diarrhea.

In rare cases, another surgery might be needed. This depends on what is causing your dumping syndrome.

Is there anything I can do on my own to feel better? — Yes. You can:

●Eat smaller meals, and eat more often – Instead of eating 3 large meals, eat smaller amounts throughout the day. Have snacks or very small meals every 2 to 3 hours.

●Eat slowly, and chew your food carefully.

●Change what you eat. Avoid foods that make your symptoms worse.

•Eat more:

-Vegetables

-Lean proteins, such as chicken, fish, eggs, beans, nuts, and soy

-Foods that are high in fiber and complex carbs, such as whole-grain breads, unsweetened cereals, wheat pasta, brown rice, or barley

-Foods with "soluble fiber" – This kind of fiber is found in fruits, oats, barley, beans, and peas.

-Foods that have protein and healthy fats, such as broiled salmon with skin. You can also add small amounts of fat to meals, for example, with a pat of butter or a tablespoon of oil.

-Dairy products without lactose, such as lactose-free milk and hard aged cheese

•Avoid:

-Foods that are high in simple sugars, such as honey, candy, sugary drinks, cookies, and cakes

-Canned fruits with sugar or syrup

-Dried fruits

-Juice that has high fructose corn syrup or is "concentrated"

-Fizzy or sugar-sweetened drinks

-Fried foods

-Hot dogs and other highly processed meats

-Alcohol

-Dairy products with lactose

•Limit:

-Foods that give you gas, such as beans and broccoli

-Drinks with caffeine

●Make sure that you get enough fluids throughout the day. But try not to drink at the same time you are eating. Wait 30 minutes after you finish eating to drink.

●Ask your doctor or nurse about support groups – It might help to find other people to talk to who have experience with dumping syndrome.

Can dumping syndrome be prevented? — Changing the way you eat after surgery is the best way to prevent dumping syndrome.

When should I call the doctor? — Call for advice if:

●Your symptoms are not getting better or are getting worse, even after changing how you eat.

●You are losing a lot of weight very quickly.

●You are having a lot of trouble eating.

●Your condition is making you feel anxious or depressed.

More on this topic

Patient education: Care after weight loss surgery (The Basics)
Patient education: Weight loss surgery (The Basics)
Patient education: Stomach cancer (The Basics)
Patient education: Esophageal cancer (The Basics)

Patient education: Weight loss surgery and procedures (Beyond the Basics)