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Gastric Bypass Dumping Syndrome – Three Foods That Cause It

As pre-op gastric bypass weight loss surgery patients we are taught to fear the mysterious dumping syndrome and in most cases we are told that avoiding sugar will prevent the occurrence of dumping syndrome. So it comes as a surprise when, after having malabsorptive gastric surgery, we experience symptoms that we think are the dumping syndrome, but still sugar has not crossed our lips. Most information about dumping syndrome after weight loss surgery focuses on avoiding sugar and suggests that some patients “get” dumping syndrome while others do not, almost as if it were an optional feature of the surgery. Other misinformation suggests that dumping syndrome disappears over time as patients adjust to surgery and eventually can eat candy.

Very little clinical research is published to help us understand dumping syndrome beyond personal experience. Combine the lack of reputable information with an abundance of urban legend about dumping syndrome and it is easy to understand the confusion.

Dumping syndrome, also known as rapid gastric emptying, is defined by the National Digestive Diseases Information Clearinghouse (NDDIC) as, “a condition in which ingested foods bypass the stomach too quickly and enter the small intestine largely undigested. It happens when the upper end of the small intestine, the duodenum, expands too quickly due to the presence of hyperosmolar (substances with increased osmolarity) food from the stomach. “Early” dumping begins at the same time or immediately after a meal.” What that means for gastric bypass patients is that food particles are absorbed too quickly by the small intestine because they have gone directly there without the digestive benefits of an intact intestine. The food is literally “dumped” into the small intestine.

To manage this food, the pancreas releases excessive amounts of insulin into the bloodstream and the body experiences the symptoms of hypoglycemia. Symptoms can start immediately or anytime within 3 hours after eating and can include nausea, vomiting, bloating, cramps, diarrhea, dizziness and fatigue. Symptoms disappear when insulin levels return to normal. Many patients who experience dumping find comfort in lying down or sipping fortified water or energy drinks served at room temperature.

The medical community generally agrees that the treatment of dumping syndrome is by avoiding certain foods that cause it. People who have stomach dumping should eat small meals that are high in lean protein, low in carbohydrates, avoid simple sugars, and should drink fluids between meals, not with meals. The following are three food groups that should be avoided in the treatment and prevention of dumping syndrome in gastric bypass patients:

Simple sugars: cookies, cakes, candy, bakery items, ice cream, sweet dairy.

Simple carbohydrates: chips, crackers, processed cereals, pasta with creamy milk sauces.

High-fat carbohydrates: Fries, fried food, fast food, grilled food with sweet barbecue sauce, cream based soups and sauces.

A diet of carefully chosen lean protein with low glycemic fresh fruit and vegetables is effective in preventing dumping syndrome. Ongoing research is beginning to implicate hyperinsulinemic hypoglycemia as the cause of rapid gastric emptying after weight loss surgery, but for you and me on the front lines suffering from the sweat and cold called dumping, what does that actually mean? I propose that we become our own personal research scientists and develop a prudent diet strategy based on current information and personal data that will allow us to avoid dumping syndrome and lead a nutritionally balanced life.

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