Dumping Syndrome After Gastric Bypass Surgery

Weight Regain in Patients with Symptoms of Post-Bariatric Surgery Hypoglycemia

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

1. Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–31. [PubMed] [Google Scholar]

2. Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25. [PMC free article] [PubMed] [Google Scholar]

3. Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53–8. [PubMed] [Google Scholar]

4. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52. [PubMed] [Google Scholar]

5. Bariatric Surgery versus Intensive Medical Therapy for Diabetes – 5-Year Outcomes. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, Navaneethan SD, Singh RP, Pothier CE, Nissen SE, Kashyap SR STAMPEDE Investigators. N Engl J Med. 2017 Feb 16;376(7):641–651. [PMC free article] [PubMed] [Google Scholar]

6. Peterli R, Wolnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250:234–41. [PubMed] [Google Scholar]

7. Patti ME, McMahon G, Mun EC, et al. Severe hypoglycaemia post-gastric bypass requiring partial pancreatectomy: evidence for inappropriate insulin secretion and pancreatic islet hyperplasia. Diabetologia. 2005;48(11):2236–40. [PubMed] [Google Scholar]

8. Goldfine AB, Mun EC, Devine E, et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab. 2007;92:4678–4685. [PubMed] [Google Scholar]

9. Marsk R, Jonas E, Rasmussen F, et al. Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986–2006 in Sweden. Diabetologia. 2010;53(11):2307–11. [PubMed] [Google Scholar]

10. Lee CJ, Clark JM, Schweitzer M, et al. Prevalence of and risk factors for hypoglycemic symptoms after gastric bypass and sleeve gastrectomy. Obesity (Silver Spring) 2015;23(5):1079–84. [PMC free article] [PubMed] [Google Scholar]

11. Hsu LK, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60(3):338–46. [PubMed] [Google Scholar]

12. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59. [PMC free article] [PubMed] [Google Scholar]

13. Hermansen K, Davies M. Does insulin detemir have a role in reducing risk of insulin-associated weight gain? Diabetes Obes Metab. 2007;9(3):209–17. [PubMed] [Google Scholar]

14. Doherty GM, Doppman JL, Shawker TH, et al. Results of a prospective strategy to diagnose, localize, and resect insulinomas. Surgery. 1991;110(6):989–96. discussion 96–7. [PubMed] [Google Scholar]

15. Willing AE, Walls EK, Koopmans HS. Insulin infusion stimulates daily food intake and body weight gain in diabetic rats. Physiol Behav. 1990;48(6):893–8. [PubMed] [Google Scholar]

16. Cai XJ, Widdowson PS, Harrold J, et al. Hypothalamic orexin expression: modulation by blood glucose and feeding. Diabetes. 1999;48(11):2132–7. [PubMed] [Google Scholar]

17. Deary IJ, Hepburn DA, MacLeod KM, et al. Partitioning the symptoms of hypoglycaemia using multi-sample confirmatory factor analysis. Diabetologia. 1993;36(8):771–7. [PubMed] [Google Scholar]

18. Carlson MG, Campbell PJ. Intensive insulin therapy and weight gain in IDDM. Diabetes. 1993;42(12):1700–7. [PubMed] [Google Scholar]

19. Robinson AH, Adler S, Stevens HB, et al. What variables are associated with successful weight loss outcomes for bariatric surgery after 1 year? Surg Obes Relat Dis. 2014;10(4):697–704. [PMC free article] [PubMed] [Google Scholar]

20. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8. [PMC free article] [PubMed] [Google Scholar]

21. Cooper TC, Simmons EB, Webb K, et al. Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery. Obes Surg. 2015;25(8):1474–81. [PubMed] [Google Scholar]

22. Munzberg H, Laque A, Yu S, et al. Appetite and body weight regulation after bariatric surgery. Obes Rev. 2015;16(Suppl 1):77–90. [PMC free article] [PubMed] [Google Scholar]

23. Bergh I, Lundin Kvalem I, Risstad H, et al. Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery. Surg Obes Relat Dis. 2016;12(4):910–8. [PubMed] [Google Scholar]

24. Laferrère B, Teixeira J, McGinty J, et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab. 2008 Jul;93(7):2479–85. [PMC free article] [PubMed] [Google Scholar]

25. Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19:1515–1521. [PubMed] [Google Scholar]

26. Papamargaritis D, Koukoulis G, Sioka E, et al. Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obes Surg. 2012;22:1600–1606. [PubMed] [Google Scholar]

27. Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R. Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol. 2009;6:583–590. [PubMed] [Google Scholar]

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657438/

Roux-en-Y Gastric Bypass—Laparoscopic Surgery

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

Roux-en-Y gastric bypass is a surgery for obesity . It changes the size of the stomach and small intestine to cause weight loss by:

  • Restricting food intake—creates a small pouch to serve as the stomach, so you cannot eat as much
  • Making the body unable to absorb as many calories from the food—bypassing the first part of the small intestine, where many of the calories from food are usually absorbed

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, :

  • Bleeding
  • Infection
  • Blood clots
  • Pulmonary embolism
  • Hernia formation
  • Bowel obstruction
  • Breakdown of the staples, allowing leakage of stomach juices into the abdomen
  • Diarrhea, abdominal cramping, and vomiting
  • Dumping syndrome—occurs after eating sweets, when food moves too quickly through the small intestine causing sweating, fatigue, lightheadedness, cramping, and diarrhea
  • The need for additional surgery
  • Complications of general anesthesia
  • Death

Long-term complications include vomiting and gallstones.

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

Copyright © EBSCO Information Services
All rights reserved.

a (Bariatric Surgery; Weight-Reduction Surgery)

Bariatric surgery. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery  . Updated October 23, 2017. Accessed December 21, 2017.

Bariatric surgery. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery. Updated December 2016. Accessed December 22, 2017.

Bariatric surgery. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery. Accessed December 21, 2017.

Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA. 2011;305(23):2419-2426.

Obesity surgery: Roux-en-Y gastric bypass. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17285-obesity-surgery/roux-en-y-gastric-bypass. Accessed December 21, 2017.

Roux-en-Y gastric bypass. Columbia University Medical Center website. Available at: http://columbiasurgery.org/conditions-and-treatments/gastric-bypass-surgery. Accessed December 21, 2017.

Roux-en-Y gastric bypass weight-loss surgery. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/gastroenterology/roux-en-y%5Fgastric%5ypass%5Fweight-loss%5Fsurgery%5F135,65. Accessed December 21, 2017.

9/2/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T483434/Bariatric-surgery  : The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445-454.

Source: https://www.denverhealth.org/conditions/r/roux-en-y-gastric-bypass-laparoscopic-surgery

Gastric bypass: Uses, procedure, and risks

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

A gastric bypass, or bariatric surgery, is a procedure that aims to help manage obesity.

About 24 million people in the United States have severe obesity, meaning that they have a body mass index (BMI) of 40 or over.

Recent statistics from the Centers for Disease Control and Prevention (CDC) show that the obesity rate in adults in the U.S. was 42.4% in 2017–2018, a significant increase from the 1999–2000 rate of 30.5%.

Obesity can increase the risk of diabetes, arthritis, high blood pressure, heart disease, and other health conditions. Healthcare professionals recommend losing weight to promote overall health.

A gastric bypass is one way to treat obesity and help a person lose weight. Keep reading to learn about the procedure and its effects.

Share on PinterestA doctor may recommend a gastric bypass to a person who is unable to lose weight through lifestyle changes.

Although diet and exercise are usually the first recommendations for losing weight, these do not work for everyone.

In cases where lifestyle changes are ineffective, a doctor may recommend surgery. A gastric bypass, or bariatric surgery, is a type of procedure that can be a sustainable, long-term option for weight loss.

Generally, these procedures work in one of three different ways:

  • Restrictive: A surgeon decreases the size of the stomach.
  • Malabsorptive: A surgeon reduces the amount of the small intestine that food can pass through.
  • Mixed: These procedures limit the intake of food and produce malabsorption.

Laparoscopic adjustable gastric banding (LAGB) is one of the types of restrictive weight loss surgeries. People sometimes refer to it as a gastric sleeve.

It involves a surgeon inserting an instrument called a laparoscope through small incisions in the upper abdomen and putting an adjustable band around the top part of the stomach to create a small pouch. The result is that the person feels fuller despite eating less.

LAGB is the least invasive gastric procedure. A doctor can adjust the band when necessary to allow an increased or reduced food intake.

Vertical sleeve gastrectomy (VSG) is a procedure more commonly known as “stomach stapling.”

During the surgery, a surgeon will permanently remove part of the stomach, limiting the amount of food that a person can eat.

They will also remove most and perhaps all of the ghrelin-producing cells of the mucous membrane layer of the stomach.

Ghrelin is a hunger hormone, so reducing its production means that a person’s appetite will decrease dramatically.

The surgeon will join the remaining parts of the stomach together using surgical staples.

In a Roux-en-Y gastric bypass (RYGB), a surgeon reduces the size of the stomach to approximately that of a golf ball.

They do this by stapling off a small pouch of the stomach away from the rest before attaching this section of the stomach to part of the small intestine called the Roux limb.

Food will pass straight from the small pouch to the lower part of the small intestine. This procedure is a malabsorptive one, as the less time food spends in the small intestine, the less the body absorbs.

The recovery time will depend on the type of procedure. In general, the more invasive the procedure, the longer the recovery time.

A person’s recovery can also depend on whether there were any complications during the surgery.

Dietary changes are necessary after a gastric bypass to ensure that complications do not occur. People should always follow doctors’ advice on what to eat.

The diet will change slowly in stages. An aftercare diet plan may involve the following stages:

  • Clear liquids: For the first day, it is only possible to have clear liquids, such as water. The aim is to ensure that the person remains hydrated but avoids anything that could irritate the stomach.
  • Liquids: After the initial day, a person may be able to introduce other liquids, such as protein shakes, slowly to ensure that they are getting enough nutrients. This stage could last 14 days.
  • Soft food: People can eat pureed food, and protein shakes become supplemental rather than the only source of protein.
  • Regular food: About 7 weeks after surgery, people can eat regular foods. It is still vital to avoid certain ingredients, however, such as added sugars and caffeine.

The dietary recommendations will vary depending on a person’s medical history and other health conditions.

Each individual will receive personalized advice from a doctor or registered dietitian to ensure that they have an appropriate diet.

As with all surgeries, a gastric bypass has risks and potential complications, such as the risk of infection.

However, the common misconception that the chance of dying from metabolic and bariatric surgery is higher than the chance of dying from obesity is false.

Information from the American Society for Metabolic and Bariatric Surgery (ASMBS) shows that the risk of death within the 30 days following bariatric surgery averages 0.13%, or approximately 1 1,000 patients.

This risk is substantially less than it is following most other operations, the ASMBS say.

Other complications

Other possible complications of bariatric surgery include:

  • Dumping syndrome: This group of symptoms occurs when food and liquids enter the small intestine rapidly and in larger amounts than normal. People may experience sweating, dizziness, palpitations, abdominal pain, nausea, vomiting, or diarrhea.
  • Leaks: Leaks can occur due to the surgery, but the surgeon will usually check for them before finishing the procedure. It is vital to have regular checkups to ensure that leaks have not occurred later on.
  • Constipation: Constipation can arise due to a person not drinking enough fluids.
  • Skin folds: These can occur due to weight loss of any kind, not just as a result of gastric bypass surgery.
  • Vitamin deficiencies: A drastic reduction in the amount of food that a person eats can cause a lack of appropriate vitamins and minerals in the diet. A dietitian can offer advice on which foods to eat.
  • Not losing weight: If a person receives gastric bypass surgery but does not substantially change their diet, they may not lose weight. In the case of LAGB, the band can widen over time. As a result, a person will be able to eat more, potentially leading to weight gain.

Gastric bypass surgery is by no means an “easy fix,” as it involves making a lot of dietary changes to allow weight loss to occur. However, it can be a significant step toward a moderate body weight for many people.

The benefits of gastric bypass surgery usually outweigh the risks. Weight loss support groups, especially those specifically for people who have had surgery, can help a person stick to their postsurgery routine and provide vital emotional support.

Source: https://www.medicalnewstoday.com/articles/gastric-bypass

Dumping Syndrome After Gastric Bypass Surgery

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

Linkedin Pinterest Gastroenterology Gastric Surgery Obesity Treatment Overview Obesity Treatment Procedures

Dumping syndrome after gastric bypass surgery is when food gets “dumped” directly from your stomach pouch into your small intestine without being digested.

There are 2 types of dumping syndrome: early and late. Early dumping happens 10 to 30 minutes after a meal. Late dumping happens 1 to 3 hours after eating. Each has slightly different symptoms, such as abdominal cramping, fast heartbeat, lightheadedness, and diarrhea.

 

What causes dumping syndrome after gastric bypass surgery?

Early dumping syndrome can occur because of the dense mass of food that gets dumped into your small intestine at an earlier stage of digestion. The intestines sense that this food mass is too concentrated, and release gut hormones.

Your body reacts by shifting fluid circulating in your bloodstream to the inside of your intestine. As a result, your intestines become fuller and bloated. Diarrhea often occurs 30 to 60 minutes later.

In addition, certain substances are released by your intestine that affect heart rate and often blood pressure, causing many of the symptoms of early dumping. This can lead to lightheadedness or even fainting.

Symptoms of late dumping happen because of a decrease in blood sugar level (reactive hypoglycemia). Reactive hypoglycemia is low blood sugar caused 1 to 3 hours after a large surge of insulin.

You are more ly to have dumping syndrome if you eat a meal heavy in starches or sugars. The sugars can be either fructose or table sugar (sucrose).

Insulin levels can increase to high levels, then lower your blood sugar too much.

Who is at risk for dumping syndrome after gastric bypass surgery?

Dumping syndrome can happen in at least 3 20 people who have had a part of their stomach removed for any reason. 

What are the symptoms of dumping syndrome after gastric bypass surgery?

Most people have early dumping symptoms. Typical early dumping symptoms can include:

  • Bloating
  • Sweating
  • Abdominal cramps and pain
  • Nausea
  • Facial flushing
  • Stomach growling or rumbling
  • An urge to lie down after the meal
  • Heart palpitations and fast heartbeat
  • Dizziness or fainting
  • Diarrhea 

About 1 in 4 people have late dumping symptoms. The symptoms of late dumping syndrome can include:

  • Heart palpitations
  • Sweating
  • Hunger
  • Confusion
  • Fatigue
  • Aggression
  • Tremors
  • Fainting

How is dumping syndrome after gastric bypass surgery diagnosed?

Your healthcare team will ly diagnose dumping syndrome your symptoms and when they occur. Tell him or her which foods or liquids give you symptoms. You may also need to have a glucose tolerance test or hydrogen breath test to help your healthcare provider diagnose you.

How is dumping syndrome after gastric bypass surgery treated?

The main treatment for dumping syndrome is changes in your diet. These include

  • Don’t drink liquids until at least 30 minutes after a meal.
  • Divide your daily calories into 6 small meals.
  • Lie down for 30 minutes after a meal to help control the symptoms.
  • Choose complex carbohydrates such as whole grains.
  • Avoid foods high in simple carbohydrates, such as those made white flour or sugar.
  • Add more protein and fat to your meals.
  • Stop eating dairy foods, if they cause problems.

Another option is to slow gastric emptying by making your food thicker. Your healthcare provider may advise adding 15 grams of guar gum or pectin to each meal. But many people don’t tolerate these additions to their food.

If dietary changes don’t help, your healthcare provider may give you some slow-release prescription medicines. In rare cases, these may help, but they often don’t work. In severe cases of dumping syndrome, your healthcare provider may suggest tube feeding or corrective surgery.

Key points

  • Dumping syndrome after gastric bypass surgery is when food gets “dumped” directly from your stomach pouch into your small intestine without being digested. There are 2 types of dumping syndrome: early and late.
  • Early dumping syndrome can occur because of the dense mass of food that gets dumped into your small intestine at an earlier stage of digestion.
  • The main treatment for dumping syndrome is changes to your diet.
  • If the dietary changes don't help, you may need to take slow-release prescription medicine.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/dumping-syndrome-after-gastric-bypass-surgery

How To Prevent Dumping Syndrome After Gastric Bypass Surgery

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

Dumping syndrome is a condition that can develop after gastric bypass surgery and occurs when food moves too quickly from the stomach into the intestines.

Dumping syndrome after gastric bypass surgery can cause uncomfortable and sometimes painful symptoms, such as abdominal cramping and diarrhea.

Patients who suffer from dumping syndrome typically experience a variety of symptoms that range in length and severity. While dumping syndrome is difficult to cope with, it can be managed and even prevented with a complete change in diet.

What is Dumping Syndrome?

During gastric bypass surgery, portions of the stomach are removed to induce weight loss. As a result, some patients may not be able to process food properly, which may cause food to “dump” into the small intestine too quickly.

Instances of dumping often occur more frequently when specific types of foods are consumed. These include fried foods, dairy products, foods that contain sugar, and specific types of fatty products.

Early Phases of Dumping Syndrome

There are two phases of dumping syndrome – the early phase and the late phase. During the early phase, patients may experience symptoms of dumping syndrome as early as 30 to 60 minutes after a meal.

Early symptoms of dumping syndrome can include:

  • Nausea
  • Vomiting
  • Rapid heartbeat
  • A feeling of fullness (even after eating small portions)
  • Lightheadedness
  • Sweating
  • Abdominal cramping

Early symptoms of dumping syndrome can be very uncomfortable and may be a sign of more symptoms to come.

Late Phases of Dumping Syndrome

The late phases of dumping syndrome often occur one to three hours after a patient eats. Symptoms can include:

  • Difficulty concentrating
  • Sweating or flushing
  • Fatigue
  • Rapid heartbeat
  • Feelings of hunger
  • Shakiness
  • Passing out

The late phases of dumping syndrome generally occur due to severe upward spikes in blood sugar levels.

It’s important to note that if you’re exhibiting signs of dumping syndrome, such as rapid heartbeat, confusion or fainting, you should never try to “ride it out.” You’ll be putting yourself at unnecessary risk.

Call emergency medical services right away.

How to Prevent Dumping Syndrome?

While seemingly unavoidable, dumping syndrome can be circumvented by completely transforming your diet.

All gastric bypass surgery patients are advised to cut cookies, sodas, sugary fruit drinks, sweet breads, cakes, alcohol and the vast majority of dairy products from their diet.

Instead, your diet should be supplemented by complex carbohydrates such as whole-wheat bread and vegetables. Fiber supplements are also recommended, as fiber improves your ability to digest your food properly and take healthy bowel movements.

It’s also essential that you keep yourself hydrated throughout the day by drinking water which can also help with the process of digestion.

Treatment for Dumping Syndrome

If you’re experiencing symptoms of dumping syndrome, your best course of action would be to see your bariatric surgeon or primary care physician. As previously noted, changing your diet will ly resolve your symptoms.

Let’s look at a few tips on how you can adjust your diet to minimize the possibility of experiencing symptoms of dumping syndrome.

1. Chew your food carefully

This may sound common sense, but it’s important that bariatric patients thoroughly chew their food.

Large pieces of food that make their way into your digestive system can cause complications that could possibly lead to dumping syndrome. To be safe consider getting into the habit of cutting your meals into tiny pieces.

2. Lie down after eating

By lying down after eating, you can slow the movement of food into your intestines.

By slowing the process of food traveling from your stomach into your intestines, you can digest the food more thoroughly and decrease the chances of experiencing symptoms of dumping syndrome.

3. Cut out alcohol completely

Bariatric patients will often learn early on that one of the things that must be cut from their diets is alcohol.

Not only can alcohol increase their ability to experience dumping syndrome, but some patients may get drunk faster due to the changes made to their bodies during surgery.

4. Avoid fluids with your meals

Liquids should only be consumed between meals and should be avoided 30 minutes before eating and 30 minutes after eating.

Most bariatric surgeons will give their patients advice on when it’s appropriate to consume liquid and how much they should drink in a single sitting.

5. Stay away from acidic foods

Acidic foods, such as citrus foods and tomatoes, aren’t easy to digest for everyone. More ly than not this may cause issues for a bariatric patient though this varies case by case.

6. Turn to low-fat cooking methods

Learn to prepare your meals by grilling, broiling, and baking as opposed to frying.

7. Increase your fiber intake

We already mentioned adding fiber supplements to your diet, but it bears repeating to drive home the fact that increasing your fiber intake can significantly improve your ability to digest food.

Speak to your bariatric surgeon to learn which fiber rich foods and supplements you should add to your diet.

8. Keep away from foods that are extremely hot or extremely cold

Temperature can act as a trigger to dumping syndrome. Eating warm meals are the safest bet.

Olde Del Mar Surgical is Here to Help

Be mindful that even with dietary changes you may still experience dumping syndrome. If that’s the case, surgery may be the only option left to fix the issue.

The vast majority of bariatric patients, however, are able to overcome and outright avoid dumping syndrome by making the appropriate changes to their diet.

With the right guidance, you can join thousands of patients who have successfully undergone surgery and now live more enjoyable, healthier lives.

Olde Del Mar Surgical can help you achieve your weight loss goals. Our professional team will be there with you every step of the way.

With our guidance and management, we can help you avoid the symptoms of dumping syndrome as you focus on losing weight and improving your health.

Source: https://oldedelmarsurgical.com/blog/dumping-syndrome-after-gastric-bypass-surgery/

How to avoid dumping syndrome after gastric bypass surgery

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

After you have gastric bypass surgery, it’s important that you adhere to your bariatric surgeon’s instructions as best as possible to lower your risk for complications as you adjust to your new, healthy lifestyle, especially in regards to diet. Considering gastric bypass surgery is a malabsorptive type of weight-loss surgery, nutrition is highly important following surgery. Failing to eat the proper types of foods could result in an uncomfortable side effect known as dumping syndrome.

What is dumping syndrome?

Dumping syndrome occurs when solid particles of food pass quickly from the stomach and into the small intestine without being fully digested.

The small intestine recognizes a concentrated form of food mass, and immediately shifts fluid from the bloodstream to the intestine to help move along the digestive process.

As a result, your intestines can become bloated, and trigger symptoms such as diarrhea, rapid heartbeat, nausea, lightheadedness, and more.

While physicians don’t understand the exact cause-and-effect relationship between dumping syndrome and gastric bypass surgery, some suspect it occurs due to the combination of having a smaller stomach and rerouted intestinal tract. The best way to avoid dumping syndrome is to take preventive measures by eating healthy, nutritious foods that can help slow down the digestive process.

Symptoms of early dumping syndrome

If you experience one or more of the following symptoms after eating, it’s possible you could be experiencing what is known as “early” dumping syndrome.

If symptoms persist, consult with your health care provider right away to determine whether immediate treatment is required.

Dumping syndrome can increase your risk for malnutrition, so it’s important to have the condition addressed before it compromises your health any further.

  • Sweating
  • Bloating
  • Nausea
  • Abdominal cramps and pain
  • Noisy stomach
  • An urge to lie down and rest after eating
  • Rapid heartbeat or palpitations
  • Dizziness
  • Diarrhea

Symptoms of late dumping syndrome

Certain foods could result in delayed dumping syndrome hours after eating a meal.

Late dumping can occur due to eating unhealthy foods high in sugar and fat, which cause your blood sugar to increase significantly up to three hours following a meal.

This condition is known as reactive hypoglycemia, described as low blood sugar caused by an influx of insulin one to three hours before dumping syndrome occurs.

Here are symptoms of late dumping syndrome:

  • Sweating
  • Tremors
  • Heart palpitations
  • Hunger
  • Fatigue
  • Confusion
  • Aggression
  • Fainting

Avoiding dumping syndrome

The best way to avoid dumping syndrome if you’ve had gastric bypass surgery is to steer clear of high-fat, sugary foods such as candy, sugary fruit drinks or sodas, cakes, cookies, pastries, sweet breads, most dairy products, and alcohol.

You can also supplement your diet with fiber supplements and complex carbohydrates such as vegetables and whole-wheat bread to encourage healthy digestion and bowel movements. Additionally, you should drink water throughout the day to prevent your body from becoming dehydrated and to complement the digestion process.

The way you eat foods can also play a role in preventing dumping syndrome. Here are more steps you can take to lower your risk for dumping syndrome:

  • Eat smaller portion sizes throughout the day. For example, eat six small meals instead of three large meals.
  • Cut food into tiny pieces that can easily be digested.
  • Chew your food slowly and thoroughly before swallowing.
  • Combine fruits or starches with proteins or fats.
  • Stop eating as soon as you begin to feel full.
  • Refrain from drinking liquids for about 30 to 45 minutes after eating meals.

While dumping syndrome is a possibility after gastric bypass surgery, you may be able to avoid this condition entirely as long as you follow your surgeon’s post-op instructions. Keep in mind that dumping syndrome is mainly caused by eating unhealthy foods high in fat and sugar.

As long as you’re dedicated to losing weight and becoming healthier after weight-loss surgery, you might be able to avoid dumping syndrome for life.

Consult with your health care provider immediately if you suspect you’re experiencing health problems associated with bariatric surgery to seek the proper course of treatment.

CarePoint Health Center for Bariatric Surgery offers a number of different weight-loss surgeries to help you meet your weight-loss goals, including sleeve gastrectomy and Roux-en-Y gastric bypass surgery. To learn more about our bariatric surgery options, contact us at 201-795-8175 and register for our free seminar.

Content on our website is for informational purposes only and does not constitute medical advice. If you are experiencing a medical emergency, please call 911. Always consult your physician before making any changes to your medical treatment.

Source: https://www.carepointhealth.org/avoid-dumping-syndrome-gastric-bypass-surgery/

Dumping Syndrome After Bariatric Surgery

Dumping Syndrome After Gastric Bypass Surgery | Johns Hopkins Medicine

Dumping syndrome is a group of symptoms that are most ly to develop if you’ve had surgery to remove all or part of your stomach, or if your stomach has been surgically bypassed to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach move too rapidly into your small bowel.

What are the Common Symptoms?

Common gastrointestinal symptoms include abdominal cramps, vomiting, nausea, a feeling of fullness, and diarrhea. Some people experience cardiovascular symptoms such as flushing, dizziness, lightheadedness, heart palpitations and rapid heart rate.

Most people with dumping syndrome experience symptoms soon after eating, usually within 15-30 minutes. In others, symptoms may occur 1-3 hours after eating. This is due to the dumping of large amount of sugars into the small intestine (hyperglycemia).

In response, the body releases large amounts of insulin to absorb the sugars, leading to low levels of sugar in the body (hypoglycemia).

Symptoms of late dumping can include: sweating, hunger, fatigue, dizziness and lightheadedness, confusion, heart palpitations and rapid heart rate, and even fainting. Some people experience both early and late symptoms.

Who Experiences Dumping Syndrome?

The most common type of weight loss surgery associated with dumping syndrome is gastric bypass (or Roux-en-Y Gastric Bypass), however some sleeve (Vertical Sleeve Gastrectomy or Sleeve Gastrectomy) patients report symptoms that appear to be dumping syndrome as well.

Dumping syndrome is not commonly, if at all, reported in band (Adjustable Gastric Band) or switch (Biliopancreatic Diversion with or without Duodenal Switch) patients. Not all gastric bypass or sleeve patients will experience dumping syndrome though.

Talk with your surgeon if you’re considering weight loss surgery about which surgery is right for you and your chances of developing dumping syndrome with each procedure.

Treatments

If you have signs and symptoms of dumping syndrome, you’re most ly to see your primary care physician, surgeon and/or dietitian at the bariatric center. Most cases of dumping syndrome improve as you learn to eat in a manner that should prevent the condition from occurring and as the digestive system adjusts.

There’s a good chance that changing your diet will resolve your symptoms. If it doesn't, your doctor may advise medications and/or surgery to address the problem. Here are some dietary treatment strategies that your doctor or dietitian may recommend and that you can try on your own.

They can help maintain good nutrition and minimize your symptoms.

Eat smaller meals

  • Try consuming about 5-6 small meals a day rather than 3 larger ones.
  • Keep portions small such as 1 ounce of meat or ¼ cup of vegetables.
  • Everyone tolerates food differently. Avoid the foods you know cause you problems.

Avoid fluids with meals

Drink liquids only between meals. Avoid liquids a half-hour before eating and a half-hour after eating. Some bariatric programs will recommend this or no fluids with meals or 30 minutes after the meal. Talk to your surgeon and/or dietitian to learn how they would to you to consume fluids in regards to mealtime.

Change your eating plan

Consume more protein-rich foods such as red meat, pork, fish, and chicken. Include some fat (healthy fats preferably) with your meal. For example olive oil, which adds calories, may help dumping symptoms. Limit your intake of foods and drinks with high sugar content. Milk contains a natural sugar, lactose, which may cause dumping syndrome depending on the person.

A small serving (½ cup) of milk, cheese, or yogurt is tolerable to most people. Consume more foods low in carbohydrates, such as grains, starchy vegetables and fruits. Avoid foods with simple sugars, including glucose, sucrose, fructose, dextrose, honey and corn syrup.

It may help to see a registered dietitian to learn which eating plan strategies are right for you in your progression following bariatric surgery.

  • Chew well – Chewing food thoroughly before you swallow can ease digestion. Cut food into very small pieces.
  • Increase fiber intake – Psyllium, guar gum and pectin in food or supplements can delay the absorption of carbohydrates in the small intestine. Pectin is found in many fruits, such as peaches, apples and plums.
  • Avoid alcohol –  Bariatric patients should be cautious with alcohol consumption anyways, but consuming alcohol may also increase your chances of experiencing dumping syndrome. As we know alcohol is also empty calories and some bariatric patients may experience a “buzz” faster following weight loss surgery.
  • Stay away from acidic foods – Tomatoes and citrus fruits are harder for some people to digest.
  • Avoid foods that are very hot or very cold – The temperature of your food may trigger dumping syndrome symptoms.
  • Use low-fat cooking methods –Prepare meat and other foods by broiling, baking or grilling.
  • Lie down after eating – This may slow down the movement of food into your intestines. This decreases the symptoms of dumping syndrome by slowing the emptying of food from the stomach. However, lying down after meals may increase your risk of acid reflux (heartburn).

Even with dietary changes, you may continue to experience symptoms associated with dumping syndrome. It’s important to manage those dumping syndrome symptoms so you stay well nourished and don’t lose too much weight too fast.

Talk to your health care provider about any symptoms you have experienced and what else you can do so you continue to CELEBRATE your weight loss success.

Please Note: Dairy products such as milk, cottage cheese, ice cream, and pudding may cause diarrhea in some people after surgery.

You may need to avoid milk products at first and then try them in small amounts as you advance your diet. Please remember that this article is not intended to provide individual medical advice.

Every bariatric patient is different and it’s important to seek medical advice from your surgeon, dietitian, and nurses at your bariatric hospital or clinic.

By Nadea Minet MS, RD, LD

Comments will be approved before showing up.

Source: https://celebratevitamins.com/blogs/articles/dumping-syndrome