Dumping Syndrome

Sounds Bad, Feels Worse

If you're planning gastric bypass surgery you need to know what dumping syndrome is and how to avoid it!

This lovely sounding syndrome results from the rapid passage (or "dumping") of undigested food into the small intestine, causing a rapid shift of fluid as the body tries to "dilute" the contents of the intestine. This shift in fluid causes cramping and diarrhea and can also result in a drop in blood pressure, causing weakness and sweating.

Why does gastric bypass make this possible?

Well, as a result of the surgery, you no longer have the valve that regulates how fast food empties out of the stomach. The surgery also causes food to enter the gastrointestinal tract at a point lower down than it's supposed to due to the first part of the small intestine having been "bypassed."

That first part of the small intestine is where sugars normally are metabolized. So basically you're now dumping sugar lower in the intestines, where they aren't equipped to handle it. The result: your body rebels!

Translation...

...eat the wrong thing and you can feel really really sick for many hours.

Here's one patient's account of what dumping syndome feels like:

Shortly after eating a food I don’t tolerate (sugar, milk, sugary milk products or starchy carbs) I begin to feel a bit disoriented, maybe dizzy and then an overall sense of confusion or panic takes over my mind and body. This is a mild state of delirium. Then I begin sweating. Profuse sweating that can completely soak my hair, my clothes; it drips and glistens on my skin. During this state of sweaty panic I feel like I’m out of my mind! A few times during extremely dramatic dumping episodes I literally thought I was dying, the state of distress was that severe.

Dumping syndrome can cause diarrhea, nausea, vomiting, increased heart rate, sweating and cramping. Symptoms can occur immediately ("early dumping") or 1-3 hours after eating ("late dumping").

Causes of Dumping Syndrome

Eating sweets or foods high in sugar

Eating too much at one meal

Having solids and fluids together

Eating foods that are fried, fatty, or greasy

How To Avoid Dumping Syndrome

Avoid/limit concentrated sugars like cookies, cake, pies, sugar, and syrup.

Read food labels for sugar content. Avoid foods with sugar listed among the first three ingredients.

Eat six small meals daily instead of three large meals.

Eat slowly.

Avoid eating and drinking at the same time. Wait 30 minutes before and after a meal to drink fluids. Drink low sugar beverages only.

A Note About Sugar

"Sugar Free" foods and drinks often contain sugar alcohols which may not be well tolerated either. So note:

Words ending in -ose are generally forms of sugar.

The following is a list of sugars and sugar alcohols to try to avoid:

barley malt

brown sugar

cane sugar

confectioner's sugar

corn syrup

corn sweeteners

dextrose

fructose

glucose

granulated sugar

honey

high fructose corn syrup

invert sugar

isomalt

lactose

lactitol

levulose

maltose

mannitol

maple syrup

molasses

raw sugar

sorghum

sucrose

sorbitol

turbinado

table sugar

xylitol

While dumping sydrome is certainly no fun to experience, the negative feedback is often a convincing motivator to stick to your post weight loss surgery diet guidelines! If you'd always wished your dentist could have just pulled out that "sweet tooth," this could be the next best thing.

I've had patient after patient tell me how their addiction to sugar was instantly broken after experiencing dumping syndrome.

Foods Best Tolerated After Gastric Bypass Surgery

Grains: plain breads, buns, bagels, and crackers, unsweetened cereals, pasta, rice

Vegetables: All

Meats/meatless protein: meat, poultry, fish, beans, peanut butter, protein powder/protein shakes

Dairy: 1%, 2% or skim milk, lowfat buttermilk, lowfat cheese, sugar-free pudding, yogurt sweetened with sugar substitute.

Fats: butter, cream, margarine, oils, fats, mayonnaise, salad dressings...IN MODERATION

Sweets: sugar-free gelatin or custard, sugar free ice cream, sugar substitutes.

Beverages: water, tea, coffee, diet soda, sugar free beverages

Foods Less Tolerated After Gastric Bypass Surgery

Grains: sweetened cereals; donuts and sweet rolls.

Fruits: frozen or dried fruit, fruit cooked or canned with sugar, sweetened fruit juice, prune juice

Vegetables: none

Dairy: Whole milk, malted or chocolate milk, sweetened custard, pudding, or yogurt

Fats/Oils: Okay, but easy does it!

Sweets: Cakes, cookies, pies, pastries, puddings, sherbert, ice cream, milkshakes, gelatin, candy, sugar, jams, jellies, honey, syrup (you know...all the yummies!)

Beverages: regular soda, sweetened drink mixes and tea, Koolaid, fruit drinks, and punch

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