What is Dumping Syndrome ?
Dumping syndrome refers to the development of a number of symptoms after one has undergone surgery to remove a part of or the entire stomach; the symptoms may also develop when one has undergone surgical bypass of the stomach to aid weight loss. Dumping syndrome is also known as gastric emptying.
Dumping syndrome is caused due to the dumping or rapid transportation of undigested materials from the stomach into the small intestine. It generally results in symptoms such as nausea and cramps in the abdomen. The symptoms differ in the severity levels, and may develop just after eating in a few affected individuals. Other patients may experience the symptoms a few hours after eating food.
Dumping syndrome generally tends to correct on its own without any medical aid, or after certain changes of the diet. Severe cases of dumping syndrome may require treatment with medications or even surgery.
Symptoms of dumping syndrome
There are many signs and symptoms of dumping syndrome. They may make an appearance just after eating, or 15 to 20 minutes post food consumption. Some of the symptoms are discussed below:
- Cramps or pain in the abdomen
- Increased rate of heart beats or cardiac palpitations
- Lightheadedness and/or dizziness
- Belching and/or bloating
Some of the symptoms that make an appearance two to three hours after eating are listed below:
- Increased sweating
- Lightheadedness and/or dizziness
- Fatigue and increased weakness
- Disorientation or confusion
- Tremors or increased shakiness
- Increased rate of heart beats or palpitations of the heart
- Increased nervousness or anxiety
- Decreased levels of blood sugar or hypoglycemia
A few individuals affected by dumping syndrome may experience the early as well as the late symptoms of the condition. A few signs such as cardiac palpitations and dizziness may occur late or early, or during both occasions. Regardless of the time when the dumping syndrome symptoms occur, they generally tend to be more severe after consumption of a meal that is high in sugar, particularly meals that are high in fruit sugars or fructose and table sugar or sucrose.
A few individuals may also develop low levels of blood sugar due to the presence of increased insulin levels in the blood. Low blood sugar generally occurs as a late symptom of dumping syndrome.
Causes of dumping syndrome
Individuals affected by dumping syndrome experience an uncontrolled and irregularly rapid transfer of gastric juices and undigested food to the small intestines. Such an abnormal acceleration of the digestive process is generally caused due to changes in the stomach that happen after one has undergone any form of stomach surgery.
For example, damage of the opening present between the first part of the small intestine and the stomach will necessitate a surgical intervention to repair or remove the affected portion. This may eventually result in the development of dumping syndrome.
Mild cases of dumping syndrome may develop in at least 25 percent of individuals who have undergone gastric bypass surgery. Dumping syndrome generally tends to develop within weeks of such a surgery or a few days after such individuals return to intake of a normal diet. The severity of dumping syndrome generally depends on the extent of the stomach parts removed or bypassed. On occasions, the condition can become seriously chronic.
It is also believed that gastrointestinal hormones may be responsible for the commencement of rapid process of food dumping.
Some of the types of surgery that may increase the risk to the development of dumping syndrome are as follows:
- Gastrojejunostomy or gastroenterostomy: It is a surgical procedure wherein the pylorus is bypassed and the stomach in directly joined to the small intestine.
- Gastrectomy: It involves the surgical removal of a part or all of the stomach, and may also involve removal of the pylorus
- Fundoplication: It is generally performed as a treatment for gastroesophageal reflux disease and is a surgical procedure wherein the upper part of the stomach is enveloped around the lower esophagus. This causes additional pressure that eases the reflux of the gastric materials into the esophagus. Injury to some nerves during this surgery can increase the risk to developing dumping syndrome.
- Vagotomy: It is a surgical procedure involving the cutting of certain nerves that go to the stomach so as to decrease the production of acid by the stomach
- Gastric bypass surgery: It is used as a treatment method for excessive obesity and involves the creation of a smaller stomach sac, which leads to decreased capacity of the stomach to store food, thereby resulting in decreased food intake and weight loss.
Dumping Syndrome Treatment
Most cases of dumping syndrome resolve on their own as affected individuals accordingly adjust the diet. However, in case the disorder does not disappear, then the doctor may recommend medications and surgery to treat the condition.
- Medications are used to reduce the symptoms of dumping syndrome as well as to decrease the rapid passage of undigested food from the stomach into the small intestine.
- Surgery is generally of the reconstructive variety and is usually done as per individual cases.
- Eating smaller meals, changing the diet to contain low-carbohydrate foods, avoidance of fluids with meals, increased intake of fiber, abstinence from alcohol, avoiding acidic foods and other dietary and lifestyle changes also aid the alleviation of dumping syndrome signs and symptoms.