Dumping syndrome after gastric bypass surgery: What you really need to know

You are thinking about gastric bypass surgery and have heard that you may experience unpleasant symptoms such as abdominal pain, nausea or diarrhea after eating.
These symptoms can occur because food passes too quickly from the stomach into the small intestine.
This is also known as dumping.
You want to know exactly what dumping means and whether it can affect you.

Dr. Thomas Vermeer, gastrointestinal surgeon at WeightWorks, has now successfully performed hundreds of gastric reductions.
Together with Dr. Dave Schweitzer, internist at WeightWorks, with years of experience in gastric bypass surgery and expert on dumping syndrome, he explains what people can expect in terms of dumping.
“It’s a nasty complaint you can get when food moves quickly from your stomach to the small intestine. Fortunately, we know what you can do to prevent it as much as possible.”
In this blog, we explain what dumping syndrome is, what symptoms you may experience, and what you can do to prevent it.
Finally, we discuss how to treat dumping if it continues to bother you.

Dumping syndrome: What is that?

Dumping syndrome occurs frequently after gastric bypass surgery.
Dumping refers to symptoms that occur when food passes from the stomach to the small intestine too quickly. When this happens, you may experience various abdominal symptoms. These symptoms occur because your body has trouble digesting and absorbing food quickly.
This is because your stomach contents move to your small intestine too quickly due to the surgery. Dumping syndrome can occur with different types of gastric bypasses, such as the gastric bypass (GBP), mini gastric bypass (Mini GBP/OAGB), and gastric sleeve (GS). In both gastric bypass and Mini gastric bypass, part of your stomach is bypassed.
This causes food to reach your small intestine faster.
This increases the risk of dumping syndrome, especially if you eat a lot of sugars.
With the gastric sleeve, a large part of your stomach is removed, leaving you with a smaller, tubular stomach.
This can also lead to dumping syndrome, although the symptoms are often less severe than with the (mini) gastric bypass.

Dumping syndrome: what causes it?

There are several causes of dumping syndrome after gastric bypass surgery.
We list below the 2 main causes of dumping:

1. Eating sugary products such as candy, cookies, fruit juice and soft drinks.
   You can think of cane sugar, beet sugar, fruit sugar and milk sugar (lactose).
2. Eating too quickly or combining food and drink so that the food passes from the stomach into the intestines rather quickly

Early and late dumping; what’s the difference?

When we talk about dumping, we can divide the symptoms into two types: early and late dumping.
Early dumping is caused by food entering the small intestine too quickly after eating.
Symptoms occur within 30 to 60 minutes after a meal.
Late dumping occurs one and a half to three hours after a meal.
It is caused by rapid fluctuations in blood sugar levels due to rapid absorption of sugars.

There are different types of complaints you can have with dumping (= symptoms dumping syndrome).

Early dumping complaints

7 Complaints you may experience with early dumping are:

1. Feeling full and bloated
2. Abdominal pain and intestinal cramps
3. Diarrhea
4. Nausea
5. Heart palpitations
6. Dizziness
7. Feeling of weakness and sometimes fainting

Late dumping complaints

8 Common symptoms you may experience with late dumping are:

1. Fluctuations in blood sugar (due to too rapid absorption of sugars)
2. Sweating (“cold sweat”)
3. Trembling and restless feeling
4. Becoming pale
5. Dizziness
6. Hunger and drowsiness
7. Changing mood and headaches
8. Fainting due to too low blood sugars

Is dumping syndrome dangerous?

Dumping syndrome can be very unpleasant and sometimes frightening, but is not usually dangerous.
The symptoms often go away on their own.
It is important to adjust your eating habits to reduce and prevent symptoms.

Preventing dumping syndrome: is it possible?

By adjusting your eating habits, you can do a lot to prevent dumping syndrome.

6 Tips Preventing Dumping Syndrome after Stomach Reduction:

1. Eat slowly and chew well: Take time for your meals (At least 20 minutes).
2. Eating Structure: Stick to the eating structure of 5-6 times a day so that you spread your food intake throughout the day.
3. Separation of food and drink: Do not drink while eating and spread your fluid intake throughout the day.
4. Avoid ‘fast sugars’: Take foods that do not contain too many fast sugars (cane sugar, beet sugar, fruit sugar and milk sugar).
   Therefore, avoid intake of soda, fruit juice, candy, pastries, sweet toppings and lactose-rich dairy products.
5. Avoid ‘junk food’: Avoid junk food as much as possible.
   These products often contain fast sugars, even if they have a salty taste.
6. Eat healthy and varied: Eat varied and moderate in your daily diet as much as possible the fast sugars.

What can I do if I experience dumping symptoms?

In addition to following the above advice, we ask you to keep a diary.
It is important to accurately record your diet and symptoms.
Together with your dietician or internist you will look for a connection between your diet and your symptoms and together you will look for a solution.

Treatment of dumping complaints

There are medications that can help control dumping syndrome, but this is usually only necessary if changes in your diet don’t work enough.
Consult with your doctor about the best treatment for your situation.

What can I do if I still suffer from dumping despite following advice?

You now know more about dumping and what are the symptoms that can accompany it. Dumping syndrome can be very annoying but is often very treatable with the right advice.
If you have an appointment at Weight Works in the near future, discuss your complaints during this consultation.
You can already keep a food diary so that you can look directly with your dietician for the right approach to your complaints. If you do not have an appointment on short notice or your symptoms are very severe, contact Weight Works and we will arrange to see you on short notice.
If your symptoms persist despite dietary adjustments, we will refer you to one of our internists with expertise in this area.
Medication is then among the possibilities to reinforce the effects of dietary adjustments.