Dumping and eating/drinking at the same time

[jay2908]

Hello,

I'd like to get some advice please. I'm not 11 years post op and generally doing well (oesophagectomy and partial gastorectomy) I've managed to stabilise my weight and starting to enjoy eating again.

Has anyone been able to get back to eating and drinking at the same time, as I do miss a cup of tea with a biscuit? Is there a trick, or way of training my digestion so that I do not get dumping and associated wind and bloating?

Any advice would be much appreciated.

Thanks,

Jay

[Hidden]

Hello Jay! I am not quite sure exactly why eating and drinking at the same time should cause the problem, other than simply being a matter of capacity and what your system can cope with at any one time. But I do know that it is the generally understood good advice.

I can understand that the dumping would be triggered with a sweet biscuit (and perhaps being taken at the same time as the tea it causes trouble by making it travel through the system quicker). Would it be the same problem with a diabetic diet type biscuit I wonder? I could certainly understand it if you took sugar with your tea, and perhaps there is a element of the sugar in the milk that makes an impact. I know this all sounds like trial and error again, but I wonder whether making tea with soya / other milk might make a difference? If you still have problems after trying all this you may have to admit defeat!

[jay2908 in reply to Hidden]

Thanks Alan, I'll give your suggestions a try. I thought that drinking whilst eating is pushing food through my stomach and to my bowels quicker than normal. Thus the food is not digested enough as it passes through by the right bacteria.

[Hidden in reply to jay2908]

That sounds logical doesn't it. I am asking for advice on this as it would help to understand what might be going on. I'll update this as and when I hear further.

[jay2908 in reply to Hidden]

I've looked up the definition of my symptoms and it's 'early dumping syndrome' - I'm hoping there might be a novel solution out there. I've seen others post op that seem to be able to eat and drinking without dumping.

[Hidden in reply to jay2908]

I looked up an old factsheet about dumping syndrome produced by CORE. It explains about 'osmotic pressure'

'The partly-digested food mixture contains a larger number of molecules than the food that was eaten because much of the starch in the diet has been broken down into sugars. A strong solution of sugar in the intestine makes the bowel contract vigorously (producing the tummy rumbling effect) so that it rapidly spreads through the length (20 feet or so) of the small bowel. A strong solution of sugar then acts like blotting paper to suck water out of the much less concentrated tissue fluids of the body. It is this sucking effect, which one can think of as an attempt by nature to equalise the concentrations of sugar in the gut and the blood, that is called osmotic pressure. This rapid shift of fluid from the body into the gut has been measured, and can be as large as 1.5 litres (3 pints). Part of it comes from the blood itself (the rest from other parts of the body), and the fall in blood volume leads to faintness, sweating, a desire to lie down, and palpitations. The extra three pints of water in the gut leads to the feeling of bloating, makes the tummy rumbling worse, and, if bad enough can end up with the passage of the excess liquid as the watery diarrhoea.'

I copied this out because the latest version of the factsheet does not include this same explanation corecharity.org.uk/wp-conte...

It also says 'It is best not to have your cup of tea or coffee at the end of the meal, but to defer it for an hour to lessen the amount of fluid entering the bowel.'

So what you may be experiencing is indeed a result of the combination of the sugar / sweetness and the liquid. My guess is that for many people this digestion process runs on a knife edge and is very easily destabilised.

[jay2908 in reply to Hidden]

Thanks Alan, this is a common issue with most patients and wondering if there was a solution other than separating solids and liquids. I will definitely try a zero carb meal with liquid and see how my gut handles it.

[gutlesswonder]

I followed this 'osmotic' dictum for several years but when I examined it closely I came to the conclusion that it was bunkum. If there was any truth in it then consumption by anyone of any carb rich foodstuff (say two slices of Easter cake and a hot-cross bun) would induce the imagined sugar/water interaction, particularly since such substrates are passed by the normal stomach within less than one hour from ingestion. The body simply did not evolve such an high risk response.

Perhaps that is why the theory is no longer advanced in the latest publications.

Since coming to that conclusion (maybe ten years ago) I have drunk normally with every meal. Typically I will have an aperitif with nibbles, followed by food (two small courses) accompanied by a large glass of wine or beer, with a small glass of water on the side. Owing to finite capacity I do not exceed these volumes of liquids. I take about one hour to eat, chewing carefully and swallowing consciously; but if in a social situation when the meal will be strung out over, say two or three hours then I am able to drink more.

I never have Dumping followed by Hypo if I remain seated for at least an hour on conclusion of the meal. However if I do rise prematurely, even to answer a phone call then, invariably I will experience Dumping followed by an Hypo.

From this I conclude that, at least in my case, D & H are mechanically induced due to postural change; also that the composition of the meal is irrelevant since I eat everything, with a preponderance of Mediterranean type cuisine.

But taking so long over every (small frequent) meal would mean sitting around for most of the day. No life at all. Hence I have trained myself to only eat twice a day - a light (slow complex carbs) breakfast and an early evening dinner. Despite this I have trouble keeping my weight down.

I should observe that my regime is contrary to all the received wisdom which is dished out, perhaps that is also bunkum? The medical profession is notorious for regurgitating the same old nostrums since that is safe and non-controversial.

Despite living in a large family of several dozen doctors it has taken me 26 years of experimentation to arrive at this more or less happy and steady state. By the same token I accept that an Ivor Lewis newbie has no choice but to follow a different routine.

Lack of appetite remains a problem.