Dumping syndrome is a group of symptoms most likely to develop after surgery  involving removal of all or part of stomach or stomach has been surgically bypassed to help lose weight. Dumping syndrome occurs when the undigested contents of food are transported or " dumped " into small intestine too rapidly. Common symptoms include abdominal cramps and nausea. Sometimes it can be vomitting.          

Some people with dumping syndrome, experience symptoms soon after eating. In others, they may occur one to three hours after eating and can range from mild to severe.            

Most often, dumping syndrome improves on its own, with adjusting diet. In more serious cases of dumping syndrome, one needs medications or surgery.                                          

SYMPTOMS -  Nausea, Vomitting, Abdominal pain or cramps, Diarrhea, Dizziness or lightheadness, Bloating, Fatigue, Heart palpitations or rapid heart rate,                                                

WHEN SIGNS AND SYMPTOMS DEVELOP LATER, THEY MAY  INCLUDE - sweating, Weakness, Fatigue, dizziness or lightheadedness, shakiness, feeling anxiety, Nervousness,  heart palpitations, rapid heart rate, fainting, mental confusion, diarrhea.                                          

Some people experience both early and late signs and symptoms. They may be worse in the aftermath of a high sugar meal, especially one that is rich in sucrose ( table sugar ) or fructose ( fruit sugar ). Some people also experience low blood sugar,  in late signs and symptoms syndrome.    
       

CAUSES - in dumping syndrome, food and juices from stomach move to small intestine in an unregulated , abnormally fast manner. Dumping syndrome may occur at least mildly in some people who have had gastric bypass surgery. Either stomach or some part of stomach is removed or bypassed. Sometimes it becomes a chronic disorder.                            

RISK FACTORS -

1. Several types of stomach surgery increase risk of dumping syndrome.

2. Gastrectomy surgery is done when a portion or all of stomach is removed. It includes removing the pylorus or stomach is directly connected to small intestine about two feet beyond the pylorus. Sometimes it is done for cancer patients. It is also called gastrojeju ostomy.

3. Vagotomy - in which the nerves to your stomach are cut in order to lower the levels of acid manufactured by stomach.

4.  Fundoplication - in which an operation sometimes performed on people with GERD ( gastro esophageal reflux disease ). It results in contents not flowing back to esophagus.

5. Gastro bypass surgery -  this operation is performed on people who are morbidly ( unhealthy manner ) obese. It surgically creates a stomach pouch that is smaller than the entire stomach, meaning one is no longer able to eat as much as once did, resulting in weight loss.

6. Certain underlying conditions also may make you more susceptible to dumping syndrome like diabetes ( undigested food passes quickly to small intestine ) ,tumour in pancreas.                                    

COMPLICATIONS - in people with severe cases of dumping syndrome, marked weight loss and malnutrition may occur. Sometimes people who lose a lot of weight may also develop a fear of eating related to the discomfort associated with rapid dumping of undigested food. They may also avoid outdoor physical activities in order to stay near to a toilet.          

TREATMENT - Most of the Dumping Syndrome cases improve with nutrional measures alone. However, if changing diet does not relieve symptoms, doctor may advise medications or surgery to slow the emptying of the stomach's contents.                                          

DIETARY CHANGES -

1. Eat smaller meals. Try consume six small meals a day rather than three large ones.
2. Avoid fluids with meals. Drink liquids only between meals and not with meals.
3. Consume low carbohydrate foods. Avoid foods with sugar contents. Consume more protein in diet and adopt a high fiber diet.
4. Increase pectin intake - pectin is found in many fruits such as peaches, apples and plums etc. It can delay absorption of carbohydrates in in the smaller intestine.
5. Use low fat cooking methods - prepare foods by broiling, baking or grilling.
6.  Consume adequate vitamins, iron and calcium.  6. With these dietary changes, you may be relieved of dumping syndrome.   

Col KG Sharma