Reviewed by:Peter F. Rovito, MD, FACS
If you’re considering getting weight loss surgery, one of the topics you’ll want to read about is “dumping syndrome,” also called “rapid gastric emptying”. The most important things to know about dumping syndrome are:
- It happens when food (especially sugar) moves too quickly from your stomach into your small intestines
- It’s common after bariatric procedures that bypass a large portion of your small intestine, like gastric bypass surgery
- It comes in two forms: early dumping (30 minutes after eating) and late dumping (over time)
- The symptoms include things like nausea, diarrhea, bloating, fainting, anxiety, and weakness
- It is usually treated effectively by diet changes and/or lying down after eating (does not usually require medical treatment)
- It is often thought of as a “good thing” by weight loss surgery patients since it discourages poor diet choices
Read the sections below for everything you need to know about dumping syndrome after weight loss surgery.
TABLE OF CONTENTS
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- Heart palpitations or rapid heart rate
- Nausea or vomiting
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.
- 75% of all gastric bypass patients experience dumping syndrome
- Dumping syndrome is likely after mini gastric bypass, duodenal switch, and gastric sleeve
- Dumping syndrome is not present after LAP-BAND®, gastric balloon, vBloc Therapy, or AspireAssist
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:
- Adjustable gastric banding (lap band surgery)
- Gastric Balloon
- vBloc Therapy
- AspireAssist Device
- Vertical banded gastroplasty (VBG)
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.
- You will need to stop eating sugars, unnecessary fat, or refined carbs
- You should eat 5 or 6 smaller meals per day (instead of 2 or 3 larger ones)
- You cannot drink liquids with your meals
- You will need to take your vitamins as prescribed by your doctor and dietitian
- You might need to lie down after eating
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.
- Patient experiences
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I'm 13 years out from gastric bypass and am keeping 150 off without much effort. I know what I did wrong when I started dumping. I get dizzy, light headed,…