Oesophageal Patients Association

Low glycemic index food and 'dumping'

Sometimes the nasty after-effects from meals might be improved with eating food from the right place on the glycemic index. There have been some questions about 'dumping' and insulin, and I thought I would try and explain things a bit. But I am not qualified in this area, so take what I write in that spirit! And please contribute your own experiences.

With a shorter digestive system (ie after an oesophagectomy / gastrectomy) and a cut vagus nerve (that controls the speed of digestive process), food rushes through the digestion system more rapidly, and will tend to trigger a 'spike' of insulin, because the body wrongly thinks it has to compensate for all the sugar that is being absorbed. This insulin spike leads to feelings of clamminess, sweatiness and so on. It is possible for frequent spikes of insulin eventually to contribute to diabetes.

We probably never knew that food had such a thing as a glycemic index! The glycemic index (GI) sets out to measure measure the effects of carbohydrates in food on our body's sugar levels. It estimates how effectively each gram of available carbohydrate (total carbohydrate minus fibre) in any particular food raises a person's blood glucose level following consumption of the food, and gives different foods a score.

So glucose rates as 100 (which is why it is so effective for rapidly restoring an unbalanced insulin:sugar ratio). Any GI score of above 70 counts as high. 56 - 69 is medium; 55 or below counts as low. So eating low GI food means that the carbohydrates in this food will not convert into sugar so rapidly. Those with diabetes may understand this already, but with the altered digestion system that so many of us have, it becomes important for us as well.

Cornflakes, lucozade, crumpets, tapioca, brown rice, white rice and jelly babies are examples of high GI food. All Bran, pitta bread, basmati rice apple juice and soya beans are examples of low GI food.

Just to make things a bit more complicated, glycemic 'load' is used sometimes. Whereas GI tells you how rapidly the carbohydrates turn into sugar, the glycemic load (GL) attempts to show how much of the carbohydrates in question are in each serving of food. Quantity rather than quality. A GL of 20 or more counts as high, 11 - 19 as medium, and 10 or lower counts as low. So carbohydrates in watermelon are high GI, but as there is not much of them, the glycemic load is low. Foods that have a low GL almost always have a low GI. Foods with an intermediate or high GL range from very low to very high GI. So looking for the GL score can be just as useful, if not more effective at times.

I am putting in links to various websits that give lists of foods and their scores, but I do not know how reliable they are:





Do not forget that people often refer to this glycemic index for weight watching and other purposes that may not trouble you. So 'good' and 'bad' for their purposes may not be relevant for you!

We have suggested eating or drinking something sweet before meals to even out the insulin reaction, and taking glucose to re-balance the insulin spike during dumping syndrome attacks. Eating low glycemic index food might make this less necessary for some people, but the principle is the same.

I know that we have enough trouble in the first place finding food that we can cope with, but low GI and GL food may be able to help at times.

10 Replies

Eating low GI foods is also important for those of us who are stage IV and did not have the operation, probably more so. This is because of the way cancer cells in the tumour feed. They are more dependant on sugar than ordinary cells so a low GI diet helps slow their growth and thus help prolong our survival.



Very interesting info.Glad youve put it on



I found this information extremely interesting. Never got anything like this from the Royal Berks Hospital - who are otherwise fantastic by the way.

Initially after the operation to remove my esophagus I was encouraged to eat all sorts of sweet things to make up lost weight and couldn't understand why this sometimes led me into all sorts of tiredness and malaise problems.

So when I read Griff's comments it was like someone removing a blindfold from my eyes because I recognized immediately some of the high carbohydrate foods that had caused me problems and the ones that had not (sometimes to my surprise) Really, really helpful. Hospital diaticians should know more about "Dumping" than they apparently do.


Bazz I have a 1984 copy of the leading medical school manual .It is quite explicit about dumping/hypoglycemia.

Notwithstanding I was hospitalized for three days in 1998 by a Consultant Endocrinologist who was determined to treat me for diabetes.

He professed complete unawareness of d/h.

Ignorance may be bliss but it's damn dangerous !


Note also that some foods such as lemon juice lower the gi of meals!


I find grapefruit very helpful,if I end the day with an whole fruit I sleep better--maybe due to less indigestion.

(Caveat--grapefruit reacts adversely with certain medications--check it out )


Thanks for this, I have been trying to narrow down what is causing me to have severe stomach cramps in the morning. I now think it is cornflakes, with milk & sugar. What I have read on here seems to confirm this. Sticking to toast for a few mornings to test the theory.


And try to be careful with what sort of bread is involved, because most normal bread is quite high on the GI.


It is important to remember that the Stomach is considered to be the largest ENDOCRINE

organ in the body.

That means it secretes , principally hormones .Hormones are the body's most powerful chemicals.They (even in the most minute quantities)act as triggers for or promoters of most bodily functions.

Thus an empty stomach produces an hormone which in turn acts on the brain to produce the feeling of hunger,whilst a full stomach secretes another hormone which has the opposite effect and leads to the sensation of satiation.

It is easy to visualize that if the stomach has been surgically reduced ,has been re-positioned and also had sections of it's sympathetic and parasympathetic nerve connections divided then this ENDOCRINE function can go haywire.

Hence the weird sensations we all experience.


Thank you for that comment. It is most helpful. We take these things for granted until we start missing them!


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