GastroIntestinal / Gastroenterology

What you should know about dumping syndrome?

Dumping syndrome, also called rapid gastric emptying, occurs when food moves too quickly from the stomach into the first section of the small intestine, known as the duodenum.

Symptoms of dumping syndrome include cramps, diarrhea, and nausea after eating, particularly after eating high-sugar foods.

Dumping syndrome can be treated through dietary and lifestyle changes. More severe cases may require medication or surgery.

Read on to learn more about the symptoms and causes of dumping syndrome, and the available treatment options.

Fast facts on dumping syndrome:

  • The condition most commonly occurs in people who have undergone gastric surgery.
  • Symptoms typically present within 30 minutes of eating.
  • Treatment can largely be managed through lifestyle and dietary changes.

Phases of dumping syndrome

Dumping syndrome
Symptoms of early dumping syndrome may include bloating, diarrhea, nausea, and stomach pain.

There are two phases of dumping syndrome:

  • Early dumping syndrome — symptoms begin 10 to 30 minutes after eating.
  • Late dumping syndrome — symptoms begin 2 to 3 hours after eating.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, approximately 75 percent of people with dumping syndrome experience early dumping syndrome, and around 25 percent experience late dumping syndrome. Some people experience both phases.


Symptoms

Dumping syndrome symptoms vary depending on the individual and the phase of the condition.

Symptoms of early dumping syndrome

Symptoms are quick to come on after eating, especially if the meal was high in sugar. People with early dumping syndrome may experience:

  • diarrhea
  • dizziness
  • feeling bloated
  • increased heart rate
  • nausea
  • skin flushing
  • stomach pain and cramping
  • vomiting

Symptoms of late dumping syndrome

Occurring within 3 hours of meals, late dumping syndrome can cause low blood sugar, which may lead to the following symptoms:

  • dizziness
  • fatigue
  • hunger
  • increased heart rate
  • skin flushing
  • sweating
  • weakness

Some people may experience symptoms of both early and late dumping syndrome.


Causes and risk factors

huge buffet
Within the stomach, the sudden arrival of a large amount of food may cause early dumping syndrome.

In healthy individuals, food moves from the stomach into the intestines over the course of several hours. With dumping syndrome, however, food particles are not stored in the stomach for long enough and are emptied into the duodenum too quickly.

Early dumping syndrome is caused by the sudden arrival of a large amount of food in the stomach. This leads to the rapid movement of fluid into the intestine, which causes discomfort, bloating, and diarrhea.

Late dumping syndrome results from the body releasing a large amount of insulin. Insulin is a hormone that helps the body absorb the sugars released from food. An increased level of insulin in the bloodstream leads to low blood sugar.

The most common cause of dumping syndrome is surgery, with the condition arising in at least 15 percent of people who have part of their stomach removed.

The following types of surgery increase the risk of dumping syndrome:

  • Gastrectomy: This type of surgery, which involves the removal of some or all of the stomach, may be carried out on people with stomach cancer.
  • Gastric bypass surgery: Typically performed to treat life-threatening obesity, gastric bypass surgery creates a small pouch in the stomach to help patients limit their food intake.
  • Esophagectomy: In this procedure, some or all of the food pipe is removed and rebuilt using another body part. An esophagectomy can be used to treat advanced esophageal cancer.

Some people may not develop dumping syndrome until years after surgery.


Diagnosis

To diagnose dumping syndrome, a doctor may carry out some or all of the following:

  • Medical history: A doctor may diagnose dumping syndrome by taking a full medical and family history, and assessing signs and symptoms. Some doctors use a scoring system to assign points to each symptom, with the total score determining the presence of dumping syndrome.
  • Oral glucose tolerance test: This test measures blood sugar to check for the low levels associated with late dumping syndrome.
  • Gastric emptying test: In this test, food containing a radioactive material is consumed. The passage of the radioactive material is tracked through the digestive system with a scanner to see how quickly food leaves the stomach and enters the small intestine.

Treatment

Lifestyle and dietary changes can be used to ease the symptoms of dumping syndrome and are often very effective.

More severe cases that are not improved with lifestyle and dietary changes may require medications or surgery.

Lifestyle and dietary changes

foods high in fiber
Dietary changes, such as consuming more high-fiber foods, may help to relieve symptoms.

The following may help relieve symptoms of dumping syndrome:

  • eat five to six small meals throughout the day, instead of three large meals
  • stop eating once full
  • chew food thoroughly to aid digestion
  • do not drink liquids in the 30 minutes before or after meals
  • drink 8 glasses of water throughout the day, but only between meals
  • lying down for 30 minutes after a meal
  • consume high-fiber foods, such as oatmeal, whole wheat breads, beans, lentils, and vegetables
  • limit or avoid high-sugar foods such as candy, cakes, fruit juice, and soda
  • limit or avoid white bread, white rice, and white pastas
  • cut out alcohol
  • increase protein intake by eating foods such as lean meats, fish, and tofu
  • remove dairy from the diet to see if that eases symptoms, as dairy is high in the natural sugar lactose
  • add pectin, psyllium, or guar gum to meals to slow the rate at which food moves through the digestive system

As dumping syndrome can affect nutrient absorption, nutritional supplements may be beneficial. However, it is advisable to discuss this with a doctor first.

Medication

If dietary changes do not improve symptoms, a doctor may prescribe an octreotide injection. This is an anti-diarrheal drug that slows the rate at which food empties into the small intestine. It can also prevent the release of insulin to reduce the risk of low blood sugar levels.

Adverse reactions to this drug include nausea and vomiting.

Surgery

If dumping syndrome does not respond to other treatments, or if it is caused by previous surgery, a doctor may suggest surgery as a treatment.

There are several surgical procedures that can treat the condition. The type that is required usually depends on the initial gastric surgery performed.

However, the National Institute of Diabetes and Digestive and Kidney Diseases warn that corrective surgery for dumping syndrome is often unsuccessful.


Complications

Dumping syndrome is a common complication of gastric surgeries. Other complications that may arise with dumping syndrome, and as a result of surgery, include:

Takeaway

It is important to contact a doctor if:

  • the symptoms of dumping syndrome are experienced
  • dietary changes do not relieve symptoms
  • there is significant weight loss due to symptoms of dumping syndrome

Many people with early dumping syndrome recover within a few months, especially if they make changes to their lifestyle and dietary habits.

In some cases, medicine or surgery may be necessary to relieve dumping syndrome.

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