Dumping Syndrome: Causes, Facts, Symptoms, Diagnosis, Treatment, Diet

Dumping Syndrome is the name given to a collection of symptoms which tend to develop when an individual undergoes a surgical procedure to remove a part of the whole stomach. It is also known by the name of Rapid Gastric Emptying, Dumping Syndrome develops when undigested contents of stomach start to move too quickly into the small bowel. Some of the symptoms observed are abdominal cramping, nausea, and persistent diarrhea. Majority of the individuals with Dumping Syndrome experience symptoms immediately after eating and for other individuals symptoms may develop a couple of hours after having a meal. Dumping Syndrome can be managed by altering the diet whereas for acute cases medications or even surgery may be required.

As stated, Dumping Syndrome occurs when the undigested content of the stomach starts to move in an uncontrolled manner to the small bowel. This results from changes that take place post a stomach surgery. Dumping Syndrome may develop after any sort of surgical procedure to the stomach or removal of the esophagus. At present, the most common cause for Dumping Syndrome is the gastric bypass surgery for weight loss. Dumping Syndrome develops a few weeks after the surgical procedure when the individual starts eating a normal diet.

• Dumping Syndrome is the name given to a pathological condition in which foods, especially sugar derivatives, move abnormally rapidly from the stomach to the small intestine
• Dumping Syndrome is basically of two types, depending on the symptoms, one is the early type of Dumping Syndrome in which symptoms are observed as early as half an hour after eating and late type Dumping Syndrome in which the symptoms are observed after a couple of hours after eating
• Individuals who have had surgery to remove a part or at times significant part of the stomach are at increased risk for developing Dumping Syndrome. In some cases, an esophageal procedure can also cause Dumping Syndrome.
• Some of the symptoms of Dumping Syndrome are nausea, vomiting, pain in the abdomen, diarrhea, abdominal bloating after eating a meal.
• Treatment for Dumping Syndrome consists of dietary modifications or surgery. In majority of cases of Dumping Syndrome, individuals improve with time and dietary modifications and do not require surgery.

Symptoms of Dumping Syndrome Include:

• Nausea
• Vomiting
• Abdominal cramping
• Diarrhea
• Fullness sensation
• Flushing
• Dizziness
• Heart palpitations
• Sweating
• Excessive Hunger
• Fatigue
• Confusion
• Syncopal episodes.

In order to diagnose Dumping Syndrome the following tests are done:

• History and Physical Examination: To begin with, the treating physician will take a detailed history and conduct a thorough physical examination to look for any history of a prior stomach surgery.
• Modified Oral Glucose Tolerance Test: This test looks at whether insulin in the body is able to adequately coordinate with the tissues in order to absorb glucose. This test is done when the individual is in a fasting state at least for eight hours. The treating physician measures the level of glucose, checks the hematocrit count, pulse, and blood pressure first before starting the test. After this, the individual is given a solution containing glucose to drink. The physician then checks the vital parameters immediately, half an hour later, and at times three hours post ingestion of the solution. Dumping Syndrome is diagnosed in people who have depreciation in the levels of blood sugars after a couple of hours of drinking the solution, there is an increase in the hematocrit count, or an increase in the pulse rate
• Gastric Emptying Test: In this test, the individual is given a bland diet like eggs mixed with a radioactive material to eat. Then the individual is analyzed in a laboratory and a radiologist interprets the results after scanning the abdomen looking for the radioactive material in the stomach. The emptying rate is measured after 2, 3, and 4 hours post eating. This is a test which definitively confirms the diagnosis of Dumping Syndrome.

Majority of cases of Dumping Syndrome tend to improve after making some subtle dietary changes and as the digestive system adjusts to the surgical procedure. There is a high likelihood that the symptoms will resolve by alteration of diet. In case if it does not resolve the symptoms, then medications may be required.

The treating physician may use medications which tend to slow the passage of food from the stomach to the small bowel but they tend to work only in severe cases. Some medications that help in this process are:

• Precose: This medication is useful in increasing the digestion period of carbohydrates. This is generally given for management of diabetes type 2 but it has been shown to be effective in individuals with Dumping Syndrome. Some of the side effects of this medication are sweating, headaches, sudden acute hunger.
• Sandostatin: This is an anti-diarrheal medication which also tends to slow down movement of food from the stomach to the small bowel. Since this medication has a high side effect profile hence it is given only to those individuals who have not responded to other medications.

A surgical procedure may be required in cases when Dumping Syndrome is not able to be managed by medication alone.

If all other measures fail to control symptoms of Dumping Syndrome then as a last resort the physician will go for insertion of a feeding tube through which food will be delivered to the small intestine in a slow manner.

Some of the suggested Diet for Dumping Syndrome are:

• Try and eat small and frequent meals rather than one large meal
• Try and limit sugar content in food and beverages
• Chew the food well before swallowing.
• Increase fiber in the diet
• Avoidance of alcohol is imperative
• Try and avoid foods with acidic content.
• Maintain a healthy diet with adequate amounts of vitamins, iron and calcium.
• Try and lie down after a meal as this slows down the progress of food into the small bowel.
• Avoid dairy products during the initial stages especially if you are having side effects like diarrhea after consuming it.
• Avoid all kinds of sweet intakes like doughnuts, pancakes, sweetened juices, pickles, yogurts, chocolates, cookies, pastries, ice creams etc.
• Take all kinds of fruits.
• Take soups that are not too hot and spicy.

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