What is the prevention of Dumping syndrome?

What is the prevention of Dumping syndrome?

Dumping syndrome is a frequent complication after surgery on the digestive system, such as gastric bypass, to treat morbid obesity. Know its symptoms and how to prevent them.

Most people who undergo gastrectomy – an operation to reduce all or part of the stomach – or gastric surgery, mainly gastric bypass for the treatment of morbid obesity, may be affected at some point during the postoperative period by a known complication as dumping syndrome. This disorder is also called colic), or another type, such as malaise, hypoglycemia (low blood glucose level), sweating, weakness or dizziness. Dumping syndrome causes the contents of the stomach to pass into the small intestine too quickly before the food is completely digested, which triggers a series of symptoms that can be gastrointestinal (cramps, nausea, and diarrhoea.

Both its incidence and severity vary depending on the type of bariatric intervention that has been performed on the patient, but following the doctor’s recommendations usually disappears after a while.

Dumping syndrome causes stomach contents to pass into the small intestine too quickly before food is fully digested.

This kind of food intolerance can manifest itself in two ways:

Early dumping: it is the most common and appears 15-30 minutes after eating, and the patient may experience a feeling of heaviness in the stomach, nausea, vomiting or diarrhoea, crampy abdominal pain, hypotension (low blood pressure ), sweats, tachycardia, flushing, weakness or dizziness.

Late dumping: occurs two to four hours after eating (especially if carbohydrate-rich foods have been eaten ), and the most common symptoms are hypoglycemia, nausea, hunger, sweating, anxiety, weakness or tremors.

Diagnosis of dumping syndrome

The diagnosis of dumping syndrome is based mainly on the clinical history (if there is a history of gastric surgery and the symptoms reported by the patient) and the physical examination. However, a test consists of administering 50g of glucose orally and checking if there is an increase in heart rate of at least ten beats per minute in the first hour to confirm early dumping or the presence of vasomotor symptoms in the case of late removal.

Taking a blood sample from the affected person when symptoms occur and analysing it to measure their glucose levels can help determine the diagnosis since this disorder is also associated with hypoglycemia.

People who have undergone surgery to lose weight or correct reflux should follow nutritional tips to prevent dumping syndrome.

In addition, the gastric emptying test by scintigraphy can be performed, which involves adding a radioactive isotope to the food to evaluate how quickly it moves from the stomach to the intestine.

What symptoms characterise it? 

  • Early dumping syndrome: It is the most frequent.
  • Nausea 
  • vomiting 
  • Abdominal pain 
  • Diarrhoea 
  • sweating 
  • Weakness 
  • Heaviness
  • pulse acceleration 
  • Late dumping syndrome: 
  • sweating 
  • Weakness 
  • redness of the face 
  • dizziness 

Dietary tips to prevent dumping syndrome

A series of dietary recommendations can help prevent or treat dumping syndrome. For example, it is significant for people who have undergone surgery to lose weight or correct gastroesophageal reflux or other types of surgeries to follow gastrically.

To prevent the risk of dumping, it is necessary to maintain a healthy diet, avoiding consuming sugar and processed foods.

The main nutritional tips to reduce the risk of suffering from dumping syndrome are:

  • Do not drink during meals. Liquids should be ingested 30 to 60 minutes before or after.
  • Distribute food in five or six meals daily, and always in small portions.
  • Limit the consumption of foods rich in sugars or simple carbohydrates ( fructose, glucose and lactose ), and never eat them alone, accompanied by meat, vegetables or fish.
  • Avoid sugar, sugary drinks and foods, especially industrial products rich in saturated fats and simple sugars.
  • Eat slowly, chew well, and remain calm after the meal for at least 15 minutes.
  • Check tolerance to lactose (milk sugar) by eating yoghurt first, then cheese, and adding milk to the diet only if no digestive problems have been observed with the previous foods.

Treatment of dumping syndrome

Dietary intervention is usually effective in relieving dumping syndrome. Still, suppose symptoms persist despite proper eating habits. In that case, your doctor may prescribe an antidiarrheal drug called octreotide (Sandostatin), administered by subcutaneous injection, which reduces gastric emptying and increases intestinal absorption of water, sodium, and intestinal absorption transit time.

Suppose neither dietary measures nor drugs are effective, and the problem is not resolved. In that case, surgery may be necessary, which usually involves the reversal of gastric bypass surgery or reconstruction of the pylorus.