Dumping Syndrome: Symptoms, Causes, and Treatment

October 22, 2024

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Dumping syndrome is a medical condition. It is also called rapid gastric emptying. When you have a surgery in your stomach or oesophagus, where it connects to your stomach, dumping syndrome occurs. Dumping syndrome is not dangerous or life threatening. Most people have symptoms that ease over time and the syndrome is not usually permanent.

Table of Contents

What is Dumping Syndrome?

When you have dumping syndrome, your stomach empties contents into the small intestine very rapidly, faster than it should. When this happens, the small intestine receives large amounts of poorly digested food. This is very uncomfortable and the patient experiences bloating, nausea, abdominal cramps, and even diarrhoea. Dumping syndrome impacts the blood sugar which fluctuates suddenly because of this.

In a normal human being, the stomach releases digested food into the small intestine slowly and in a controlled manner. “Gastric motility” denotes the way the stomach moves food through the digestive process. For gastric motility to happen normally, the body involves muscles, nerves, and signals from hormones to coordinate. These signals, tell your stomach when and how to empty food into the small intestine. When this coordination is affected, the pyloric valve at the bottom of the stomach, simply opens and dumps undigested food into the small intestine. This uncontrolled gastric emptying results in the small intestine having to cope with a whole lot of undigested food. To do this, it draws in extra fluid volume and releases extra hormones. All this activity results in the symptoms that people with dumping syndrome experience shortly after eating.

In some people, the symptoms appear a few hours after they have eaten. This happens because when the small intestine receives concentrated sugar content, it signals to your pancreas which release extra insulin to regulate the blood sugar. As a result, your blood sugar drops sharply resulting in hypoglycaemia. The patient may experience, faintness, shakiness, and palpitations of the heart.

Symptoms of Dumping Syndrome

There are two types of dumping syndrome. One is early dumping syndrome in which the patient experiences symptoms between 10 to 30 minutes after eating something. The symptoms are:

Feeling bloated or full after eating
Nausea
Abdominal cramps
Diarrhoea
Flushing
Dizziness and light-headedness
Rapid heart rate and acceleration

The other type of dumping syndrome is called late dumping syndrome. These symptoms appear about 2 or 3 hours after eating:

Sweating
Flushing
Weakness and fatigue
Dizziness and light-headedness
Heart acceleration or rapid heart beat
Jitters and shakiness
Cold sweats
Brain fog
Hunger

Causes of Dumping Syndrome

There are various causes of dumping syndrome. Surgically, it could be caused by any of the following surgeries:

Gastrectomy, where some part or all the stomach is removed
Bariatric surgery that is done for weight loss
Pyloroplasty which is a surgery on the pyloric valve at the bottom of your stomach.
Esophagectomy in which a part of the oesophagus is removed
Vagotomy or a surgery where the vagus nerve is cut to reduce stomach acid
Nissen fundoplication which is surgery that sews the top of the stomach around the oesophagus

Dumping syndrome can also be caused by various other diseases like:

Diabetes mellitus
Cyclic vomiting syndrome
Autonomic dysfunction
Exocrine pancreatic insufficiency
Duodenal ulcers
Zollinger-Ellison syndrome
Functional dyspepsia
Cannabis hyperemesis syndrome

Diagnosis and Treatment

Various tests can diagnose dumping syndrome. They are:

Oral glucose tolerance test: You are made to drink a glucose solution and your blood sugar is measured before and after you drink it. The test also measures your hematocrit (red blood cell count). If the test sees a higher hematocrit after you drink the solution, it means that large volumes of fluid are moving to your intestines from your bloodstream. If your blood sugar drops 1 to 3 hours after this, it indicates late dumping syndrome.
Hydrogen breath test: You are made to drink a glucose solution and the hydrogen levels in your blood are measured. If your small intestine is overloaded, the test results are positive which indicates that the glucose is not well absorbed in your intestine.
Upper endoscopy: A thin flexible tube with an attached lighted camera is used to examine the oesophagus, stomach, and duodenum. This can reveal any structural problems and any other causes for dumping syndrome.
Upper GI series: In this test, your healthcare providers will take a series of video X-rays called fluoroscopy which can show how fast the solution travels from your oesophagus, stomach and reaches your upper intestine.
Gastric emptying test: This is a test that shows how fast food moves through your stomach to your small intestine. To do this, a small (trace) amount of radioactive material is added to your meal. A scanner can easily reveal how the food is moving by tracking the radioactive material.

Treatment of dumping syndrome is usually through dietary changes. If these changes do not produce results, then you may need medication. Medicines may include:

Octreotide acetate: The medicine inhibits certain hormones that slows down the gastric emptying and transit time to the small intestine. It also suppresses insulin. It is an injection given in two forms: either daily or monthly once depending on whether it is short or long acting form.
Acarbose: This medicine regulates your blood sugar and slows doen the rate at which your body absorbs carbohydrates.

Doctors do not recommend medications in the long-term since they have side effects. Very rarely, another surgery may be suggested to fix dumping syndrome. These reconstruction surgeries may be:

Modifying or reconstructing a part of your stomach that is not working properly.
If you have had a gastric bypass operation, it may have to be reversed or converted to a less severe form

Managing Dumping Syndrome

Generally dietary guidelines are given to those with dumping syndrome:

Smaller, frequent meals: Smaller meals are recommended and you must eat slowly and chew thoroughly.
You must avoid carbohydrates, sugar and milk products: Instead have complex carbohydrates such as whole grains. Eat unsweetened whole grain cereal, oatmeal, bread, rice and pasta.
Eat more protein and healthy fats: Fats slow down the digestion and provide a steady form of energy. You can have eggs, meat, poultry, fish, nut, and nut butters. Butter, mayonnaise, avocados, salad dressings can also be included.
Eat more dietary fibre: When your meal has a lot of bulk in it, the transit time is slowed down as also the sugar in your digestive system.
Lying down on your back for 30 minutes after eating: This helps with slowing down the gastric emptying and maintaining your blood pressure during digestion.
Avoiding fluids 30 minutes before or after eating food: The fluids enhance motility and hence it is better to avoid them.

Conclusion

Dumping syndrome is a common problem that affects people recovering from surgery. You can manage the condition by adjusting your diet. Mild cases resolve within three months and severe cases take up to 18 months to resolve. Even after you make dietary changes, it may take several weeks before you notice any improvement.

Frequently Asked Questions

1. What is dumping syndrome?

It is a condition that is caused by food moving very quickly from the stomach to the small intestine. Patients have symptoms like diarrhoea, nausea, and light-headedness after a meal.

2. What are the causes of dumping syndrome?

Stomach or oesophagus surgery causes it. Often other surgery like gastric bypass surgery can also cause it.

3. How is dumping syndrome diagnosed?

It is diagnosed based on the symptoms that the patient is showing. An oral glucose tolerance test can confirm the diagnosis.

4. What are the treatments for dumping syndrome?

Treatment involves a lot of lifestyle and dietary changes. Having smaller meals, eating slowly, chewing food properly and lying down for 30 minutes after a meal helps.