Post-Gastrectomy Dumping Syndrome

Gastrectomy--removal of part or all of the stomach--usually is done for a life-saving reason, such as fighting cancer or eliminating large amounts of excess weight. While the benefits of the procedure are obvious, it does come with side effects. One of these is "dumping," a nasty reaction that occurs after a gastrectomy patient eats. While there's no real treatment during a dumping episode, there are ways to prevent the condition from happening as frequently.

Identification

"Dumping" is a collection of gastrointestinal and other symptoms that develop after a person eats. These dumping symptoms usually come on right after eating, but in some cases, dumping occurs a few hours after a snack or a meal. The majority of people who experience dumping have undergone some sort of surgery that removes part of the stomach or bypasses it, such as a gastrectomy (removal of the stomach) or gastric bypass Roux-en-Y surgery (which reroutes the digestive system so that the stomach is smaller).

Symptoms

What happens when dumping occurs? Symptoms are mainly gastrointestinal when they develop during eating or right afterwards--bloating, belching, nausea, cramps, vomiting, and diarrhea are common. Non-gastrointestinal symptoms can include dizziness, a feeling of exhaustion, and rapid heartbeat. If dumping occurs some hours after a meal, symptoms include dizziness, fatigue, sweats, rapid heartbeat and tremors as well as emotional symptoms like strong anxiety and fear. Severe symptoms include mental confusion and fainting. Diarrhea may also occur. Some people experience both "early" and "late" dumping symptoms over a period of time, and symptoms can ranger from mild to severe.

Reason

Why does the body react in such a dramatic way to food? In the vast majority of dumping cases, it's because the now-smaller stomach is sending too much partially digested food down into the small intestine at once. The upper end of the small intestine swells up, causing pain, and water rushes into the small intestine, provoking diarrhea. In addition, the pancreas reacts to the influx of food by sending out a wave of the hormone insulin. This extra insulin makes blood sugar levels drop, and leads to hypoglycemia.

Lifestyle Changes

The best way to prevent dumping is to avoid foods that provoke the condition. If you've noticed that certain foods set off an episode of dumping, put them on your "to avoid" list so you can avoid them in future (or at least know what's going to happen when you eat them). Sugary foods tend to provoke dumping--stay away from simple sugars, such as high-fructose corn syrup, sucrose, fructose and dextrose. Eat protein with your all meals. Drink water throughout the day, in small sips; this helps keep blood sugar levels stable.

Other Treatments

If you suffer from severe dumping, your doctor may prescribe certain medications that should slow the movement of food through your digestive system. Precose, a drug that delays the absorption of carbohydrates, usually is given to people who suffer from dumping due to type 2 diabetes. Sandostatin is an injectable anti-diarrhea drug that slows the movements of the intestines. This drug can cause other unfortunate gastrointestinal side effects such as flatulence, bloating, large stools and diarrhea. In very severe cases of dumping, restorative surgery can be performed on the stomach.