Dumping

[david001]

Here's an extract from a website which is written in layman's english which readers might find interesting

What is dumping syndrome?

Dumping syndrome is a group of signs and symptoms that develops most often in people who have had surgery to remove all or part of their stomach, or in whom much of their stomach has been surgically bypassed to help lose weight. It may occur early or late.

Early dumping

This typically starts during a meal or within 15-30 minutes following a meal. It is thought to be caused by foods which are high in sugar passing too quickly from the stomach pouch into the small intestine. Because the food is very concentrated (dense) it attracts a correspondingly large amount of fluid into the gut causing it to become stretched and painful. Early dumping syndrome symptoms include:

Nausea

Vomiting

Abdominal pain, cramps

Diarrhea

Dizziness, lightheadedness

Bloating, belching

Fatigue

Heart palpitations, rapid heart rate

Late dumping

This typically occurs 1-3 hours after eating. Late dumping syndrome is caused by marked changes in blood sugar levels. When sugar is eaten it is quickly absorbed into the bloodstream triggering a rapid rise in blood sugar levels. The pancreas responds by secreting an equally large amount of insulin to soak up the excess blood sugar. However, sometimes the pancreas produces too much insulin, resulting in a low blood sugar level (hypoglycaemia). Late dumping syndrome symptoms include:

Sweating

Weakness, fatigue

Dizziness, light-headedness

Shakiness

Feelings of anxiety, nervousness

Heart palpitations, rapid heart rate

Fainting

Mental confusion

If you experience late dumping syndrome you need to eat a glucose sweet (anything sweet will do) immediately. Then eat something which is lower in sugar – eg. crackers, wholemeal biscuits, yoghurt etc. The box below provides some general tips to avoid both early and late dumping:

TIPS TO AVOID DUMPING SYNDROME

Avoid problem foods. Everyone tolerates food differently — avoid food that you know cause you problems.

Eat smaller meals. Try taking five or six small meals a day rather than two or three larger ones.

Avoid drinking liquids with your meal. Drink up to 15 minutes before eating and wait at least I hour after your meal before drinking again.

Reduce sugar and simple carbohydrates in your diet. Eat more low-carbohydrate foods. In particular, concentrate on a diet low in simple carbohydrates such as sugar (found in sweets, chocolate, ice-cream, cakes, biscuits etc). Read labels on packaged food before buying, with the goal of not only avoiding foods with sugar in their ingredients list, but also looking for (and staying away from) alternative names for sugar, such as glucose, sucrose, fructose, dextrose, honey and corn syrup. Artificial sweeteners are acceptable alternatives. Consume more protein in your diet, and adopt a high fibre diet with more fruit and vegetables.

Increase pectin intake. Pectin is found in many fruits such as peaches, apples and plums, as well as in some fiber supplements. It can delay the absorption of carbohydrates in the small intestine.

Avoid acidic foods. Tomatoes and citrus fruits are harder for some people to digest.

Use low-fat cooking methods. Prepare meat and other foods by baking or grilling.

Vitamins and Minerals. Make sure you are taking your vitamin and mineral supplements as prescribed.

Lie down after eating. This may slow down the movement of food into your intestines.

Dumping syndrome tends to decrease over several months as the pouch and small intestine learn to work better together. Although dumping is uncomfortable, it is not dangerous

[margie1]

Hi david001

I have had an oesophagectomy and I still experience early and late dumping syndrome even after 3 years post surgery I find I'm ok with certain foods one Day and not on another also I find it hard to find foods with low or no amount of sugar ! Do you know the limit or amount of sugar I should be looking for in certain goods please?

[david001 in reply to margie1]

Hi Margie

I'm afraid I don't. Everyone is different when it comes down to diet and so keeping a diary is useful and you will soon find out what effects you and when.

I keep off all high sugar foods esp simple sugars found in desserts and confectionery and certain drinks. Slow release/complex starches are beneficial. Some people are advised to keep off all drinks when eating as this hastens the 'early dumping' effect. You no longer have a reservoir where food is held up in order for the body to get its digestion synchronised.

BUT having a sweet or two when late dumping should lessen that effect neutralising the insulin spike. So then I would keep some glucose tablets handy. Other people on here may have some other handy tips.

Hope that helps

[deveretth in reply to margie1]

How much weight have you lost with your situation?

David

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[brucemillar]

Thank you. A good easy to follow article.

I would question the very last sentence "it is not dangerous" It can be if, like me, you pass out on occasions. That loss of consciousness can be very dangerous. My last fall has left me me with two fractures in my Thoracic Spine.

[david001 in reply to brucemillar]

Thanks Bruce

Good point and like you have passed out many times esp in the first year but over time the effects seem to have lessened esp when we watch what we eat/drink. I've also found that I can sense when it is starting and so sit down or better lie down somewhere.

[brucemillar in reply to david001]

David

Interesting. I am starting to be very aware indeed of any symptoms that may lead to me passing out. The slightest twitch has me reaching for the Dextrose (my chosen remedy). I have come to the conclusion that taking Dextrose at the earliest sign of trouble will avoid the eventual crash (should I do nothing).

That raises the question of possible overdosing on Dextrose and taking too much glucose onboard. I have to say that to date I have suffered no ill effects from the Dextrose. That gives me some confidence.

I am on Acarbose tablets (soon to be converted to patches) These slow down the bodies sugar absorption.

SO my new regime now is:

Acarbose three times daily with food.

No obvious sugars - cakes, biscuits, sweets, tea & coffee etc.

Eating smaller and more frequently.

That has kept me in the vertical for four weeks now with no requirement for the Dextrose.

Pretty dull diet really. I do cheat with occasional bottle of Rose spread over an evening.

[deveretth in reply to brucemillar]

When i was working back in the spring and started feeling spaced out and realizing my oxygen levels were depleted. Have you heard of the energy drink NOS in the USA? it's actually very popular. Drinking a can snapped me out of the duldrums. that's

not what you are supposed to do, but it's an immediate remedy.

and then i would go to the doctor to consult what else i should do.

David

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[deveretth in reply to brucemillar]

I have my Iron and Hemoglobin levels tested every week. There are also Iron and Hemoglobin Home Test Kits. Iron and Hemoglobin is a measure of your

day to day fitness which requires Oxygen in your blood. 7.6 with 12 being normal requires an immediate Blood Transfusion is my situation this week. I go to the Good Samaritan Hospital in Babylon NY tommorrow morning for blood and iron packs. it will take all day. Be aware when you start getting spaced out or even pass out your levels are critical.

David

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[haward]

Two and a half years on from my operation and I still can't predict what will set me off. For example lunch in the pub last Friday was chilli, a largish meal, two and a half pints of Bath Hare and I was fine. Last night I had a medium sized steak and ale pie and a pint of Adnam's Ghost Ship. I was very tired even before I got to the bottom of my beer. I just keep o trying to eat three meals a day and hope it will get better. Gradually it is getting better. I am putting weight back on and the dumping is becoming less frequent. I guess it'll never disappear completely. But I'm here.

[brucemillar in reply to haward]

Haward

Sounds like your taste in ale is the problem. Drink Guinness.

[david001 in reply to brucemillar]

Thanks Bruce

No truer word said in jest

My consultant advised me to go onto the Guinness asap as it's rich in iron and should help with the iron malabsorption which so many of us suffer with.

Alcohol is also renowned for exacerbating early dumping and we should avoid drinks with our meal (whenever possible). Difficult when it's a good pub

[haward in reply to david001]

Hi David

if there's one thing that never causes me dumping - it's alcohol. After the op even a half pint took for ever but now I can have 2-3 pints over the course of lunch or an evening without difficulty. Maybe I am just lucky. I am not fond of Guinness; I have to have a good English Ale (or a Scots 80/-)!

Regards

Haward

[lonestray]

Five years and three months have passed since I've had my stomach totally removed and I'm pleased to tell that in the past three months I've not experienced dumping. In fact I'm enjoying my food.

Each morning I eat half a can of beaked beans. A half an hour later I drink a cup of coffee, followed an hour or so later with some cake or Tiramisu.

For lunch I eat many different types of veg, (as may as seven) and a variety of fish, chicken or meat. For my evening meal I have pasta, a cup of coffee with some biscuits or cake, an orange and finish the evening off with some stewed apple. I'm sleeping better and am up in the early morning for my run. I would dearly like to regain some of the weight I lost. Now I'm past my 84th birthday I aim to discover what more is possible.

I've always tackled life in my own way as I never experienced a home or family life from the age of two. It is often said, that without a proper family life and a good education ones chances of success are poor. How wrong that is? I'm still learning as that's what life is all about. Hang in there, think positive.

[deveretth in reply to lonestray]

What was your stomach replaced with? I was told about a feeding bag that avoids the stomach issues directly into your intestines. I didn't think it was

wierd to be a vegetarian. But issues for Iron Depletion and Hemoglobin

levels i think a meat diet is better. i am 60 years old now.

David

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