Dumping syndrome refers to a group of symptoms including weakness, abdominal discomfort, and abnormally fast bowel evacuation that occur after meals.
Dumping syndrome, also called rapid gastric emptying, is a group of symptoms associated with the rapid movement of the contents of the stomach (partially digested food, fluids, and saliva) into the duodenum, the first part of the small intestine. There are two types of dumping syndrome: (1) early dumping syndrome, which occurs 10 to 45 minutes after consuming a meal and (2) late dumping syndrome, which occurs two to three hours after a meal.
Late dumping is caused by the excess release of insulin responding to the rapid movement of food containing too much simple or refined sugar into the duodenum. The high levels of insulin cause lowering of the blood sugar (glucose) level so that the person experiences symptoms of hypoglycemia (abnormally low blood sugar).
Dumping syndrome is common in people who have had gastric surgery (surgery on the stomach).
Signs of early dumping syndrome include abdominal pain and cramping related to swelling of the intestine; a feeling of fullness (being bloated) after a meal; rapid and irregular heart rate (pulse); low blood pressure; shortness of breath; dizziness, weakness and fainting; sweating; flushing of the face or skin; and nausea, vomiting, and diarrhea.
Signs of late dumping syndrome are related to low blood sugar (hypoglycemia). They include a feeling of hunger, sweating, a feeling of shakiness, anxiety, exhaustion, faintness, and difficulty concentrating. Some people have both types of dumping syndrome.
In general, dumping syndrome can be expected after gastric bypass surgery. Healthcare providers obtain a history of the problem, asking such questions as the following: When did you have bypass surgery? What signs and symptoms are you having? When do the signs and symptoms occur in relation to eating meals? Are you drinking fluids with meals? How long does it take for you to feel relief?
Additional laboratory and diagnostic testing may be done. A glucose tolerance test checks how well a person's body uses insulin to absorb glucose (sugar) in the diet. A gastric emptying test examines how quickly food moves through the digestive system. X-rays to examine the small intestine may be acquired to determine whether there are any signs of blockage or other surgical complications. An endoscopy * may be done to view the upper gastrointestinal system * to determine whether there are any other conditions that may cause the problem, such as ulcers, swelling of the stomach lining, or cancer.
Treatment for dumping syndrome generally requires changes in eating, diet, and nutrition, including:
Treatment for early dumping syndrome includes lying down for 45 minutes to an hour to allow symptoms to pass. Treatment for late dumping syndrome includes eating a small amount of sugary candy or drinking a sweetened juice until the symptoms of low blood sugar pass.
Treatment is usually prescribed by a doctor who has specialized knowledge of and experience in the treatment of people with gastrointestinal diseases, or who is a surgeon who specializes in gastric bypass surgery. People with dumping syndrome are often referred to a dietitian * , who can assist them with diet and nutritional problems associated with gastric bypass surgery and dumping syndrome.
There are also medications that can be prescribed that may relieve the problem. Some of these drugs work by slowing down the process of digestion, and others work by reducing the secretion of gastric acid. In some cases, surgery may need to be done.
People may find that the ingestion of one or more specific foods causes dumping syndrome to occur. As they identify the foods that cause the problem, they can then avoid those foods completely. Some general strategies to minimize or prevent dumping syndrome are the same as those used for treatment described previously.
As the body adjusts to the changes in digestion resulting from gastric surgery, the incidence of dumping syndrome often decreases. Early dumping syndrome usually resolves about four to six months after surgery. Late dumping syndrome may continue for a year or more after surgery.
See also Diarrhea • Hypoglycemia
Rao, Satish S. C., et al., eds. Handbook of Gastrointestinal Motility and Functional Disorders. Thorofare, NJ: SLACK, 2015.
MedlinePlus. “Dumping Syndrome.” National Library of Medicine, National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/imagepages/19830.htm (accessed March 23, 2016).
National Institute of Diabetes and Digestive and Kidney Diseases. “Dumping Syndrome.” (accessed March 23, 2016).
Obesity Action Coalition. “What Is Dumping, and Why Am I Experiencing It?” http://www.obesityaction.org/educational-resources/resourcearticles-2/weight-loss-surgery/what-is-dumping-and-why-am-iexperiencing-it (accessed March 23, 2016).
Academy of Nutrition and Dietetics. 120 S Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Toll-free: 800-877-1600. Website: http://www.eatright.org (accessed March 23, 2016).
National Institute of Diabetes and Digestive and Kidney Diseases. Office of Communications and Public Liaison NIH, Bldg. 31, Room 9A04, 31 Center Drive, MSC 2560, Bethesda, MD 20892-2560. Telephone: 301-496-3583. Website: http://www.niddk.nih.gov (accessed March 23, 2016).
Obesity Action Coalition. 4511 N Himes Ave., Suite 250, Tampa, FL 33614. Toll-free: 800-717-3117. Website: http://www.obesityaction.org (accessed March 23, 2017).
* endoscopy (en-DAS-kuh-pee) is a type of diagnostic test in which a lighted tubelike instrument is inserted into a part of the body to view body structures.
* upper gastrointestinal system consists of the mouth, esophagus, and stomach.
* dietitian is a person with specialized knowledge and experience in treating people who have problems with food or eating. Also sometimes called a nutritionist, although dietitians usually have a specific amount of education and training and nutritionists do not.