What Is Dumping Syndrome? | Gastroenterology

Dumping Syndrome

Overview of dumping syndrome

Dumping syndrome is a medical condition in which the stomach empties its contents faster than normal into the first part of the small intestine (duodenum). Dumping syndrome is also known as rapid gastric emptying.

People with dumping syndrome experience symptoms such as nausea and abdominal cramps. These symptoms occur because your small intestine does not absorb nutrients from the food that is not properly digested in your stomach. If you have had any type of gastric surgery, such as gastric bypass surgery, you are more likely to have dumping syndrome.

Doctors classify into two specific types:

  • Early dumping syndrome and
  • Late dumping syndrome.

Each type occurs at different times after eating and causes different symptoms.

What are the symptoms of dumping syndrome?

The symptoms of dumping syndrome depend on the type of dumping syndrome you have.

Early discharge syndrome usually occurs within 30 minutes after the end of the meal. If you live with early dumping syndrome, your symptoms may include:

  • Nausea
  • Vomiting, diarrhoea, or abdominal cramps.
  • Feels bloated
  • Weakness
  • Dizziness
  • Cold sweats

Symptoms of late emptying syndrome usually appear 2 to 3 hours after a meal. Your characteristics may include:

  • Low blood sugar (hypoglycaemia).
  • Weakness
  • Cold sweats
  • Dizziness
  • Fast or irregular heartbeat

Causes of dumping syndrome

Typically when you eat, food moves from your stomach into your intestines over several hours. In the intestines, nutrients from food are absorbed and digestive juices break down the food even more.

With dumping syndrome, food moves too quickly from your stomach into your intestine.

  • Early dumping syndrome happens when the sudden influx of food into your intestine causes a lot of fluid to move from your bloodstream into your intestine as well. This extra fluid causes diarrhoea and bloating. Your intestines also release substances that speed your heart rate and lower your blood pressure. This leads to symptoms like a fast heart rate and dizziness.
  • Late dumping syndrome happens because of an increase in starches and sugars in your intestines. At first, the extra sugar causes your blood sugar level to rise. Your pancreas then releases the hormone insulin to move sugar (glucose) from your blood into your cells. This extra rise in insulin causes your blood sugar to drop too low. Low blood sugar is called hypoglycemia.

Risk factors

Surgical replacement of your abdomen increases the risk of dumping syndrome. These surgeries are usually done to treat the esophagus, but they are also part of the treatment of stomach cancer, esophageal cancer, and other conditions. These surgeries include:

Gastrectomy, in which part or all of the abdomen is removed.

  • Gastric bypass surgery, which is done to treat chronic obesity. This surgically creates a stomach pouch smaller than your stomach, which means you cannot eat as much as you used to. It connects the small intestine with this bag in the form of a gastrojejunostomy.
  • Esophagectomy, in which all or part of the tube between the mouth and the stomach is removed.

Diagnosis

Your doctor may use some of the following methods to determine if you have dumping syndrome.

  • Medical history and evaluation. Your doctor can often diagnose dumping syndrome by taking a medical history, particularly if you’ve had stomach surgery, and evaluating your signs and symptoms.
  • Blood sugar test. Because low blood sugar is sometimes associated with dumping syndrome, your doctor may order a test (oral glucose tolerance) to measure your blood sugar level at the peak time of your symptoms to help confirm the diagnosis.
  • Gastric emptying test. Radioactive material is added to food to measure how quickly food moves through your stomach.

Treatment options

You may be able to relieve symptoms of dumping syndrome by making a few changes to your diet:

  • Eat five to six smaller meals throughout the day instead of three big meals.
  • Avoid or limit sugary foods like soda, candy, and baked goods.
    Eat more protein from foods like chicken, fish, peanut butter, and tofu.
  • Get more fibre in your diet. Switch from simple carbohydrates like white bread and pasta to whole grains like oatmeal and whole wheat. You can also take fibre supplements. The extra fibre will help sugar and other carbohydrates get absorbed more slowly in your intestines.
  • Don’t drink fluids within 30 minutes before or after meals.
    Chew your food completely before you swallow to make it easier to digest.
  • Add pectin or guar gum to your food to thicken it. This will slow the rate at which food moves from your stomach to your intestine.

For more severe dumping syndrome, your doctor may prescribe Actriotide (Sandostatin). This medicine alters the way your digestive system works, reducing the emptying of your stomach into the intestines. It also inhibits the release of insulin. You can take this medicine as an injection under the skin, into the muscle of the hip or arm, or through an IV. Some of the side effects of this medicine include changes in blood sugar levels, nausea, pain where you received the injection, and foul-smelling stools.

Complications

Dumping syndrome is a complication of stomach reduction or bypass surgery.

Other complications associated with this surgery are:

  • Problems with the absorption of nutrients.
  • Anaemia, due to lack of vitamin B-12, folic acid, or iron.
  • Osteoporosis, or weak bones, is caused by calcium absorption problems.
  • Poor absorption of nutrients.
  • Weak bones, also known as osteoporosis, are the result of poor calcium absorption.
  • Anaemia or low red blood cell count, without adequate absorption of vitamins or iron.

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