Problems with Digesting Fat After Weight-Loss Surgery

Problems with Digesting Fat After Weight-Loss Surgery

Problems with Digesting Fat After Weight-Loss Surgery | Johns Hopkins Medicine

Linkedin Pinterest Gastroenterology Gastric Surgery Obesity Treatment Overview Obesity Treatment Procedures

If you are severely obese and haven’t been able to lose weight, your healthcare provider may recommend weight-loss surgery. Weight-loss surgery (bariatric surgery) may help you lose weight. Losing weight can lower your risk for weight-related problems heart disease, diabetes, sleep apnea, high blood pressure, and arthritis.

Most bariatric surgeries are called restrictive surgeries because they limit how much food you can eat. Another type of bariatric surgery is called controlled malabsorption.

This surgery makes it impossible for your body to break down and absorb food in a normal way.

If your healthcare provider recommends this type of surgery, you may have a surgery called biliopancreatic diversion with a duodenal switch. (BPD-DS).

What BPD-DS does

BPD-DS is a complicated type of bariatric surgery. It changes the anatomy of your digestive system in several ways:

  • It removes most of your stomach.
  • It bypasses most of your small intestine. Food you eat won’t flow through the bypassed part of the intestine.
  • It sends digestive enzymes from your pancreas to an area much farther down in your small intestine.

These changes mean that your body does not have the time or the space to break down the fats, proteins, and carbohydrates from foods you eat into smaller particles that your body can absorb. This causes you to lose weight quickly. You are also ly to keep the weight off longer than with restrictive type weight-loss surgeries. But you may also have more long-term complications.

Problems with absorbing fat

After BPD-DS, you will be at high risk for many nutritional problems (deficiencies). The surgery makes it harder for you to digest and absorb fat.

This can mean your body doesn’t get enough of vitamins. A, D, E, and K. These vitamins are fat-soluble. This means they dissolve in fat when they are inside your body.

If you cannot absorb fat, you won’t be able to fully absorb or store these vitamins.

You need vitamin D to help absorb calcium, so you can have too little calcium in your body after BPD-DS. This is a very real concern, especially for women. Women are more ly to have weak bones (osteoporosis). Studies show that 4 years after BPD-DS, about 2 3 people will be low in vitamins A, D, and K. Half will be low in calcium.

Problems with absorbing fats may cause:

  • Steatorrhea. Undigested fats cause loose and frequent bowel movements. These are often hard to control. You may have cramping, foul-smelling diarrhea, and lots of gas.
  • Vitamin deficiencies and related diseases. Symptoms of these vitamin deficiencies include rashes, bruising or bleeding, night blindness, and weak bones that are more ly to break.
  • Calcium deficiency. BPD-DS makes it harder for your body to absorb calcium and vitamin D. Both of these nutrients are important for healthy bones. Low levels of calcium in your body can cause broken bones.
  • Vitamin E deficiency. This problem is rare but it can happen with fat malabsorption. Symptoms include numbness or tingling in your arms and legs. This is because your nerves aren’t working as they should. Other symptoms include muscle weakness and vision problems. You are also less able to fight off infections.

How to live with fat malabsorption after BPD-DS

After BPD-DS you will need to follow a diet high in protein. You will need to take high doses of fat-soluble vitamins every day. You may also need other dietary supplements. Limiting the amount of fat in your diet will help prevent steatorrhea. Some people may also need to take pancreatic enzyme supplements.

The American Society for Metabolic and Bariatric Surgery recommends that you start taking vitamin A, D, and K supplements about 2 to 4 weeks after BPD-DS surgery. This will help prevent nutritional deficiencies. You may also need calcium, iron, B-complex, and multivitamins. Talk with your healthcare provider to find out what supplements you should take.

You'll need to take these supplements for the rest of your life. You will also need to be tested regularly by your healthcare provider to prevent complications. Your healthcare provider may need to change these guidelines to fit your particular condition.

Remember that fat malabsorption is the reason you lose weight after the surgery. But it could cause long-term complications. These risks can be managed, but they will last for the rest of your life.

You will need a regular, lifelong follow-up schedule with a healthcare provider. Work with your healthcare provider to look at all of the risks and benefits of BPD-DS as you get ready for bariatric surgery.



Pancreas: Function, Location & Diseases

Problems with Digesting Fat After Weight-Loss Surgery | Johns Hopkins Medicine

The pancreas is an abdominal organ that is located behind the stomach and is surrounded by other organs, including the spleen, liver and small intestine. The pancreas is about 6 inches (15.24 centimeters) long, oblong and flat. 

The pancreas plays an important role in digestion and in regulating blood sugar. Three diseases associated with the pancreas are pancreatitis, pancreatic cancer and diabetes.

Function of the pancreas

The pancreas serves two primary functions, according to Jordan Knowlton, an advanced registered nurse practitioner at the University of Florida Health Shands Hospital. It makes “enzymes to digest proteins, fats, and carbs in the intestines” and produces the hormones insulin and glucagon, he said.

Dr. Richard Bowen of Colorado State University's Department of Biomedical Sciences wrote in Hypertexts for Pathophysiology: Endocrine System, “A well-known effect of insulin is to decrease the concentration of glucose in blood.” This lowers blood sugar levels and allows the body's cells to use glucose for energy. 

Insulin also allows glucose to enter muscle and other tissue, works with the liver to store glucose and synthesize fatty acids, and “stimulates the uptake of amino acids,” according to Bowen.

Insulin is released after eating protein and especially after eating carbohydrates, which increase glucose levels in the blood.

If the pancreas does not produce sufficient insulin, type 1 diabetes will develop.

Un insulin, glucagon raises blood sugar levels. According to the Johns Hopkins University Sol Goldman Pancreatic Cancer Research Center, the combination of insulin and glucagon maintains the proper level of sugar in the blood.

The pancreas' second, exocrine function is to produce and release digestive fluids.

After food enters the stomach, digestive enzymes called pancreatic juice travel through several small ducts to the main pancreatic duct and then to the bile duct, according to the Medical University of South Carolina’s Digestive Disease Center. The bile duct takes the juice to the gallbladder, where it mixes with bile to aid in digestion.

Location of the pancreas

“The pancreas is located in the upper abdomen behind the stomach,” Knowlton said. The right end of the pancreas is wide and called the head. From the head, the organ tapers to the left. The middle sections are called the neck and body, while the narrow end on the left side of the body is called the tail. 

The Hume-Lee Transplant Center at Virginia Commonwealth University described the pancreas as “j-shaped.” The portion of the pancreas called the uncinate process bends backward from the head and underneath the body, according to the Pancreatic Cancer Action Network.

Pancreas pain

Intense pancreatic pain is usually associated with acute pancreatitis.

It can be hard to identify pancreas pain and evaluate pancreas diseases because the organ sits deep in the abdomen, according to The National Pancreas Association.

Other signs that the pain may be pancreatic include jaundice, itchy skin and unexplained weight loss. If you are experiencing pancreas pain, consult your doctor.


The National Institutes of Health defines pancreatitis as inflammation of the pancreas, happening when “digestive enzymes start digesting the pancreas itself.” It can be acute or chronic, but both forms should be taken seriously and may lead to additional health problems.

Chronic pancreatitis

There are up to 23 cases of chronic pancreatitis per 100,000 people per year worldwide. In just the United States, it results in more than 122,000 outpatient visits and more than 56,000 hospitalizations per year, according to the Cleveland Clinic.

“Chronic pancreatitis is a persistent inflammation (greater than three weeks) of the pancreas that causes permanent damage,” Knowlton said.

The condition is often caused by “heavy, ongoing” alcohol consumption, but she added that there are other causes, including “those that cause acute pancreatitis attacks.

” Other causes may be cystic fibrosis, high levels of calcium or fat in the blood and autoimmune disorders.

Symptoms include upper abdominal pain, nausea, vomiting, weight loss, and oily stools. According to Peter Lee and Tyler Stevens, in an article for the Cleveland Clinic, “clinically apparent” oily stools (steatorrhea) do not appear until “90 percent of pancreatic function has been lost.”

“Chronic pancreatitis requires dietary modifications, including a low-fat diet and cessation of alcohol [intake] and smoking,” Knowlton said. Chronic pancreatitis does not heal and tends to worsen with time, and “treatment options are mostly for pain relief.

” She added that treatments “may include a pancreas stent or, for severe cases, surgery (either a lateral pancreaticojejunostomy, or a Whipple procedure).

” Pancreatiocojejunostomies are designed to decrease pancreatic leakage while the Whipple procedure removes the head of the pancreas where, according to the Mayo Clinic, most tumors occur. 

There may be a link between chronic pancreatitis and pancreatic cancer. According to the University of California Los Angeles Center for Pancreatic Diseases, “Recent studies reveal a 2-5 times increase in the incidence of pancreatic cancer in patients with chronic pancreatitis from a variety of causes.”

Acute pancreatitis

“Acute pancreatitis is inflammation of the pancreas (lasting less than three weeks), that is most often caused by gallstones,” said Knowlton. It usually comes on suddenly and disappears within a few days of treatment. In addition to gallstones, Knowlton said that causes “may include medications, high triglycerides, high calcium in the blood and high alcohol consumption.”

Pancreas pain is the chief symptom of acute pancreatitis, according to Medscape. The pain is usually severe and sudden. It increases in severity until it becomes a constant ache.

This pancreas pain is felt in the upper abdomen. The Mayo Clinic noted that the pain can radiate through to the back, and Knowlton pointed out that it might be worse after eating.

Other symptoms of acute pancreatitis include nausea, vomiting, fever and diarrhea.

According to Knowlton, “This patient often looks acutely ill, and requires hospitalization (typically for three to five days), intravenous (IV) hydration, nothing by mouth (for bowel rest), pain medication, treatment of underlying conditions, and possibly a radiologic procedure called an endoscopic retrograde cholangiopancreatography (ERCP), which can more specifically target the problem.” If the acute pancreatitis was caused by gallstones, doctors may recommend removing the gallbladder.

Pancreatic cancer

It is hard to diagnose pancreatic cancer early. The Mayo Clinic noted that symptoms typically don't occur until the cancer has advanced. Knowlton said, “Unfortunately, symptoms can be vague, but can include abdominal pain, jaundice, severe itching, weight-loss, nausea, vomiting, and digestive problems.” 

Making matters even more complicated is the pancreas' deep-in-the-abdomen location. The NIH pointed out that as a result, tumors cannot usually be felt by touch. Because of the difficulty of early diagnosis and the rapidity with which pancreatic cancer spreads, the prognosis is often poor. 

Risk factors for pancreatic cancer include smoking, long-term diabetes and chronic pancreatitis, according to the National Cancer Institute.

According to the American Cancer Society, pancreatic cancer usually begins in the cells that produce pancreatic (digestive) juices or in the cells that line the ducts. In rare occasions, pancreatic cancer will begin in the cells that produce hormones.

According to the University of Texas MD Anderson Cancer Center, to diagnose pancreatic cancer, doctors typically conduct physical exams, blood tests, imaging tests, endoscopic ultrasounds and tests and biopsies. Treatment options include surgery, radiation, chemotherapy and therapies targeted to attack cancer cells without harming normal cells.

Artificial pancreas

When a person's pancreas isn't functioning properly or has to be removed, doctors may replace or supplement it with an artificial pancreas.

These devices that automatically monitor blood glucose and provide the appropriate insulin doses are often called closed-loop systems, automated insulin delivery systems, or autonomous systems for glycemic control, according to the Food and Drug Administration. 

In a 2014 study published in the journal The Lancet Diabetes & Endocrinology, researchers found that an artificial pancreas offer people with type 1 diabetes a reliable way to keep glucose levels in check, when compared to other treatments.

“Our study confirms that both artificial pancreas systems improve glucose control and reduce the risk of hypoglycemia compared to conventional pump therapy,” study author Ahmad Haidar, of Institut de Recherches Cliniques de Montreal, said in a statement.

[Artificial Pancreas May Improve Type 1 Diabetes Treatment]

Additional reporting by Alina Bradford, Live Science contributor.

Additional resources

Related pages about the human body

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Digestive Problems – Digestive System Disorders

Problems with Digesting Fat After Weight-Loss Surgery | Johns Hopkins Medicine

Between gas, constipation and acid reflux, digestive issues are among the most unpleasant ailments—and the touchiest topics to broach. But getting to the root of your problems can ease discomfort and allay embarrassing symptoms. Learn how to tame your tummy with these eight astounding facts about your digestive tract.

We really are what we eat.

Bacteria from our intestines influence our digestive tract's health, according to Gerard Mullin, MD, professor at the Johns Hopkins School of Medicine and author of The Inside Tract: Your Good Gut Guide to Great Digestive Health.

These friendly organisms break down hard-to-digest foods, produce nutrients and help keep harmful bacteria in check. When the balance of good guys versus bad falls whack—because of antibiotics, too much junk food or even stress—you can develop gas, bloating, constipation and irritable bowel syndrome (IBS).

Too much bad bacteria is even linked to obesity, according to some research. Why? They stop the stomach from telling the brain it's full. To keep your belly's ecosystem thriving, eat plenty of fruit, vegetables and whole grains.

These soluble fiber–rich foods stimulate good bacteria growth as they move through your intestines, giving you a healthy gut and immune system, says Dr. Mullin. Yogurt and probiotic supplements can also fortify your defenses.

When you're stressed, your stomach is, too.

There's a reason your belly clenches at the sound of bad news. Your gastrointestinal tract is directly wired to the nervous system, explains Dr. Mullin.

When your body perceives danger, your nervous system shuts down blood flow to the stomach so it can direct all its energy toward self-defense, says Brenda Powell, MD, a physician at the Center for Integrative Medicine at the Cleveland Clinic.

“When stress is chronic, the body releases inflammatory chemicals, which can break down the GI system's lining and function,” she adds. To restore harmony, de-stress with meditation, exercise, yoga or spending time with supportive friends. And if you're in the middle of a stress attack, take slow, deep belly breaths to calm down.

Even a lotof gasis normal.

Most people think they break wind more often than their neighbor, when in fact they aren't setting any records. According to gastroenterologist Anish Sheth, MD, author of What's Your Poo Telling You, the average person sounds the horn 14 to 23 times a day, releasing up to four pints of gas.

Still, if flatulence is putting a damper on social gatherings, Dr. Sheth recommends refraining from beans, cabbage, apples, sweet potatoes, carrots, prunes and other foods high in soluble fiber (yes, those same ones that are good for your gut) for up to six hours before your outing.

Or take a probiotic pill Culturelle or Align.

There's a reason you feel ill after eating greasy food.

Big, greasy meals can trigger the gastrocolic reflex—your intestines' way of cleaning house before new guests arrive. “Fat turbo-charges the colon,” causing forceful contractions, says Dr. Sheth.

The result: Food that hasn't left your belly gets the heave-ho, sending you scuttling for the nearest bathroom.

How do you stop this gut reaction? Stick with small meals, and keep oily indulgences to a minimum, says Dr. Sheth.

Eating too much and being overweight are the top reasons for GERD.

One five Americans suffers from gastroesophageal reflux disease, aka GERD or acid reflux. While certain foods trigger heartburn and nausea, the most common cause of GERD is abdominal pressure from overeating, being overweight or both, says Dr. Sheth.

In fact, your odds of getting acid reflux climbs as your weight does, even if your body mass index (BMI) is where it should be. Someone with a normal BMI of 22.

5 is more at risk for GERD than someone with a lower BMI, according to David Johnson, MD, past president of the American College of Gastroenterology. That's why he tells GERD sufferers to drop three to five pounds, even if they're not overweight.

Some people, especially those on the heavier side, may need to lose more to end symptoms, but even modest weight loss can help, says Dr. Johnson.

Poor diet is the most common cause of constipation.

Feeling a bit bound up? You're not alone. According to the American College of Gastroenterology, constipation is one of the most frequent gastrointestinal complaints in the U.S., with at least 2.5 million doctor visits each year. In most cases, a low-fiber diet is to blame.

If you don't get anywhere near the recommended 25 grams of fiber, increase your intake gradually over two to three weeks and drink plenty of water while you do.

Here's one menu to meet the daily requirement: 1/4 cup black beans (3g); 1 cup shredded wheat (5g); two slices of whole-wheat bread (4g); apple (3g); orange (3g); ½ cup cooked brown rice (2g); ½ cup cooked spinach (2g); and ½ cup of peas (4g).

For a quick fix, opt for supplements, suggests Larry Schiller, MD, President-elect of the American College of Gastroenterology. Insoluble fiber supplements, Metamucil, psyllium husk or Unifiber, work best.

The more slowly food moves through your belly, the longer you'll stay full.

Your body processes food in order of its complexity. Low-fiber and -protein simple carbohydrates, white bread, rice and pasta, zip through your system quickly. While they might give you a shot of energy, the effects are short-lived, leaving you hungry again soon.

Conversely, foods high in protein or fiber stick around longer, keeping you full longer. According to Bonnie Taub-Dix, M.A., R.D.

, author of Read It Before You Eat It, eating well-balanced meals and snacks will satisfy hunger quickly, so you don't devour as much, and will fill you up, so you're less ly to hit the vending machine in an hour.

Good choices for filling snacks: apple slices with peanut butter, carrot sticks with hummus and almonds with dried fruit. Munch on these instead of junk and digestive problems linked to overeating and being overweight probably won't bother you anymore.

Bland diets aren't the best treatment for acid reflux.

Some doctors tell GERD patients to stay away from favorite foods and drinks chocolate, wine, spaghetti sauce, citrus and more. “There's little evidence that those global restrictions make a difference,” says Dr. Johnson.

So you don't necessarily need to nix your top treats. Still, Dr. Johnson recommends refraining from eating anything you know gives you trouble.

Avoiding big, fatty meals three to four hours before bedtime can also help curb symptoms.

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Weight Loss Balloons Linked to 12 Deaths, FDA Says

Problems with Digesting Fat After Weight-Loss Surgery | Johns Hopkins Medicine

From the WebMD Archives

June 6, 2018 — Five more deaths are linked with weight loss balloons, bringing the total number of deaths associated with the devices to 12 since their approval in 2015, the FDA says.

The two devices involved are the ReShape, made by ReShape Lifesciences, and Orbera, made by Apollo Endosurgery.

It is the third time the FDA has issued alerts about the products, says Deborah Kotz, an FDA spokeswoman. The agency also issued alerts in February and August 2017.

In late May, the FDA put in place labeling changes to reflect the risks. “The FDA continues to work with the companies that manufacture these liquid-filled intragastric balloons to better understand the complications associated with these devices, and to ensure the product labeling adequately addresses these risks,” the FDA’s William Maisel, MD, said in a statement.

Four of the five newly reported deaths involved the Orbera device. Of the 12 total deaths, seven were U.S. patients, the FDA says. Gastric perforation, when a hole forms in the wall of the stomach, large bowel, or small intestine, was reported with four of the deaths. The perforations happened from 1 day to 3 1/2 weeks after balloon placement. It is a known risk with the procedure.

“I'm concerned, but I certainly don't think at this point we would make any changes in our recommendation regarding safety and effectiveness,” says Eric DeMaria, MD, president-elect of the American Society for Metabolic and Bariatric Surgery.

The total number of procedures, and the number of people helped by the devices, need to be taken into account, he says.

Both companies said they were cooperating with the agency and that patient safety is their top concern. In a statement, Apollo says it welcomes the stronger labeling changes. It says more than 295,000 Orbera balloons have been distributed worldwide and the death rate globally is less than .01%.

Many patients with the procedure have not only obesity, but also conditions such as high blood pressure or cholesterol that can also impact their health, the statement says.

In a conference call for media Monday, Dan Gladney, CEO of ReShape Lifesciences, noted that one of the five newly reported deaths involved the ReShape system. He said that patient had a gastric perforation, which was repaired. But the patient developed a blood clot in the lung while still in the hospital and died.

More than 5,000 ReShape procedures have been done since the FDA approval in 2015.

In addition to the reported deaths linked to the balloon devices, the FDA has received hundreds of other complaints over the years. Doctors, other health care providers, device makers, and the public can file reports via the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database online.

Some patients report, for instance, blue-green urine. “Blue-green urine could be a sign of balloon deflation, a risk that was already known to the FDA and which appears on the product labeling,” Kotz of the FDA says.

Other known possible complications include pancreatitis, an inflammation of the pancreas that can happens if the balloon injures it, and deflation of the balloon, which could lead to bowel obstruction. The balloon could also migrate.

The balloon devices require no cuts and are the least invasive of the bariatric procedures, says DeMaria, who’s also a weight loss surgeon at St. Mary's Medical Center in Richmond, VA.

A doctor inserts a gastroscope through the patient’s mouth to place the balloon and fill it with sterile saline. It then inflates, taking up stomach space.

The patient is told to follow a diet and exercise program, and the balloon is removed after 6 months.

DeMaria says the device  works best for people with a body mass index (BMI) greater than 30 but less than 40.

A person 5 feet, 8 inches tall who weighs 200 pounds has a BMI of 30.4. If the person weighs 270, the BMI is 41.1.

People at the lower end of that BMI range ''are supposed to have a coexisting condition,” such as high blood pressure, to be considered a candidate, DeMaria says.

Other bariatric options for weight loss are more invasive, such as a sleeve gastrectomy, which makes the stomach a fraction of its original size, and a gastric bypass, which divides the stomach and reconnects the smaller stomach to the lower end of the intestinal tract.

People who have the balloon procedures should be closely monitored, experts agree. Gastric perforation ''is not a subtle thing,” DeMaria says. Symptoms may include stomach pain, nausea, and vomiting, he says. But after the balloon is inserted, ''patients may have some abdominal pain and some nausea.”

Always consult a doctor if you are worried about your symptoms.

Eric DeMaria, MD, president-elect, American Society for Metabolic and Bariatric Surgery; bariatric surgeon, St. Mary's Medical Center, Richmond, VA.

Deborah Kotz, spokeswoman, FDA.

Statement, FDA, June 4, 2018.

Statement, Apollo Endosurgery, June 4, 2018.

Conference call, ReShape Lifesciences, June 4, 2018. “What is gastrointestinal perforation?”

© 2018 WebMD, LLC. All rights reserved.


Dumping Syndrome After Gastric Bypass Surgery

Problems with Digesting Fat After Weight-Loss 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.