Dumping Syndrome - Definition, Symptoms & 5 Effective Treatments
Reviewed by: Peter F. Rovito, MD, FACS
Dumping syndrome, or “rapid gastric emptying”, is extremely common following bariatric surgery procedures that bypass the majority of your stomach. Believe it or not, for many weight loss surgery patients it is actually a good thing despite its unpleasant symptoms…
Dumping syndrome refers to several symptoms that may occur following the surgical removal of some or all of the stomach. Symptoms, which are usually present after eating, range from nausea to diarrhea to fainting (more on symptoms in the next section).
When food (especially sugar) moves too quickly through the stomach, it is “dumped” into the small intestine. The body has a difficult time handling this rapid “dumping” and responds by adding a large amount of fluid to the small intestine. This fluid is the cause of patient dumping symptoms.
Fortunately, gastric dumping syndrome does not usually require medical treatment to be cured. In most cases, a change in diet is all that is needed (we will review other treatments further down the page).
For some, sticking to an appropriate diet following surgery can be extremely difficult. The risk of patient dumping is a foreboding consequence of not following your dietitian or nutritionist’s diet recommendations.
As long as you do not stray from your prescribed bariatric diet, you should not experience dumping syndrome. For this reason, many patients view it as a “blessing in disguise” since it helps to keep their diet (and therefore their health and weight loss goals) on track.
"Patient dumping does not usually require medical treatment."
Symptoms: Early Dumping – 30 Minutes After Eating, Bloating, Diarrhea, Nausea; Late Dumping – Form of Hypoglycemia, Anxiety, Fainting, Weakness
There are two kinds of patient dumping: early and late. Both occur after a meal, especially after eating foods high in fat, refined carbohydrates or sugar (table sugar or natural sugar like that found in fruit)…
- Early Dumping Syndrome
Early Dumping Syndrome occurs within 30 minutes of eating a meal. In addition to eating foods high in fat, carbohydrates or sugar, it can also be brought on by eating foods that are too cold or too hot or by drinking liquids during your meal. Early symptoms include…
- Heart palpitations
- Rapid heart rate
- Late Dumping Syndrome
Late Dumping Syndrome is a form of hypoglycemia (low blood sugar). When you ingest too much sugar, your now smaller stomach does not digest it properly so your intestines absorb and deposit too much of it into your blood stream. Your body compensates by releasing more insulin which makes your blood sugar drop. Late symptoms include…
- Heart palpitations
- Mental changes such as problems concentrating or feeling confused
- Rapid heart rate
- Strong feelings of hunger (because your body craves more sugar to balance the increase of insulin in your system)
Interestingly, some patients’ tolerance for the items which have caused dumping syndrome in the past can change with time. For example, some patients who cannot tolerate sugar immediately after surgery may be able to handle it in small amounts several years out.
Bariatric Procedures That Are at Risk Of Dumping Syndrome: Gastric Bypass, Gastric Sleeve, Duodenal Switch, Mini Gastric Bypass
As many as 70% of gastric bypass patients experience dumping syndrome, but less than 5% of these people who do have serious symptoms (1). As a general rule, the more of your stomach that has been removed, the more likely you are to dump.
Following are the bariatric surgery procedures that separate or remove part of the stomach. Patients undergoing these surgeries have a higher risk of dumping…
- Laparoscopic gastric bypass surgery (up to 80% of patients)
- Gastric sleeve surgery
- Biliopancreatic diversion with duodenal switch
- Mini gastric bypass surgery
Bariatric surgery procedures that will probably not cause patient dumping include…
A couple of other procedures not related to weight loss surgery can also result in dumping, including Fundoplication (improves Gastro-esophageal Reflux Disease) and Vagotomy (reduces stomach acid).
Finally, conditions that affect blood sugar levels such as diabetes can increase your chances of experiencing patient dumping.
Considering weight loss surgery & concerned about dumping syndrome?
Most surgeons offer free seminars and/or one-on-one consultations that teach you about your weight loss surgery options, potiential side effects like dumping syndrome and their office’s specific results.
The most successful treatment for dumping symptom is a change in your diet…
- Don’t eat sugars, unnecessary fat or refined carbohydrates. If you’re like many people, this may sound next to impossible, but don’t worry too much just yet. Many patients’ cravings for these foods completely change after surgery. And if the cravings don’t stop immediately, the fear of dumping can have a strong psychological impact that could cause you to lose the taste for these foods. If you can’t figure out the food culprit causing your dumping, keeping a good free diet journal is your best bet (by the way, a food journal is a good idea anyway for several reasons. See our Bariatric Diet page for more on this). A food journal will allow you to track and remove foods that could be causing patient dumping. Often times the natural sugars found in fruits or juices are the issue. Fruit can be okay as long as you have plenty of protein, fiber and complex carbohydrates in your diet (such as whole grains or vegetables). Keep in mind that fruits like apples and peaches contain pectin, which could actually prevent some of the sugar from being absorbed by your small intestine. Other non-fruit acidic foods can also upset your system, including eggs, yogurt and organ meat such as liver. Finally, try cooking your meals without the use of oils.
A note about sugar
Giving up sugar can be tough to imagine. The good news is that you don’t necessarily need to be entirely deprived.
There are a wide range of sugar substitutes and sugar-free products now available that can be included in your meal plan. Talk with your support program’s dietitian for suggestions.
- Eat five or six smaller meals a day instead of three bigger ones. This can make digestion easier on your system and won’t “shock it” with so much at once.
- Don’t drink anything with your meals as this can increase the speed at which your food passes through your stomach and into your intestine. In addition to avoiding gastric dumping syndrome, avoiding liquids during and after meals will also help you reach and maintain your goal weight. Liquids during meals flush your food through your stomach, leave you feeling hungry and may cause you to overeat. You should not drink anything during or up to an hour after each meal.
- Take your vitamins. Your bariatric doctors or dietitian will most likely prescribe bariatric vitamins after surgery – don’t forget to take them as prescribed!
- Lie down after eating. Gravity can pull food through your system more quickly when sitting down or standing, so lie down after eating to help your food pass through more slowly. Keep in mind that patients suffering from gastro-esophageal reflux disease (GERD) may worsen their symptoms by lying down after eating. If you suffer from GERD, your doctor may recommend that you wait 3 hours before lying down after a meal.
If a change in your diet and eating habits doesn’t work, you may need to resort to medications or even surgery to cure dumping syndrome. Keep your doctors informed of your symptoms so they can determine whether medication or surgery should be considered.
[ Last editorial review/modification of this page : 09/26/2016]