Dumping syndrome is a collection of symptoms that occur when your stomach empties its contents too rapidly into your small intestine. It’s usually associated with gastric surgery. Rapid gastric emptying causes large amounts of undigested food to flood your small intestine. You may experience nausea, abdominal cramping and blood sugar reactions.
Dumping syndrome is a medical condition in which your stomach empties its contents into your small intestine more rapidly than it should. It’s also called rapid gastric emptying. When your stomach empties too quickly, your small intestine receives uncomfortably large amounts of poorly digested food. This can cause symptoms of nausea, bloating, abdominal cramps and diarrhea. It can also cause sudden blood sugar changes.
Your stomach usually releases digestive contents into your small intestine in a gradual, controlled manner. The way your stomach moves food along through the digestive process is sometimes called your “gastric motility." Many things are involved in gastric motility: muscles, nerves and hormone signals coordinate together to tell your stomach how and when to empty. If any of these things are impaired, it can throw this coordination off.
Uncontrolled gastric emptying means that the valve at the bottom of your stomach, the pyloric valve, simply opens and dumps everything out, before your stomach has finished digesting. When your small intestine receives this mass of under-digested food, it makes adjustments to try and accommodate it. It draws in extra fluid volume and releases extra hormones. These adjustments cause the symptoms that people experience shortly after eating.
Some people experience another set of symptoms a few hours later. This happens because of blood sugar changes. If your small intestine receives a concentrated serving of sugar content, it may set off alarms in your digestive system. Your small intestine may signal your pancreas to release extra insulin to regulate your blood sugar. This can cause your blood sugar to drop sharply (reactive hypoglycemia). This drop can cause faintness, shakiness and heart palpitations.
Dumping syndrome most commonly happens as a complication of surgery on your stomach, or on your esophagus where it connects to your stomach. An estimated 20% to 50% of people who have had stomach surgery develop some symptoms of dumping syndrome. It's most common in people who have had surgeries that remove or bypass large portions of the stomach, such as gastrectomy or gastric bypass surgery. Occasionally, it can also occur with certain gastrointestinal diseases.
Under normal circumstances, dumping syndrome is not dangerous or life-threatening. A severe case can cause rapid weight loss and nutritional deficiencies. Persistent, unmanaged diarrhea can cause dehydration, but these complications can usually be managed or prevented with self-care. Most people have mild symptoms that ease over time. Dumping syndrome is not usually permanent.
Dumping syndrome has two phases, each with its own set of symptoms. You may experience one or both phases.
Early dumping syndrome symptoms occur within 10 to 30 minutes after you've finished eating. You may experience:
Late dumping syndrome begins to show signs about two to three hours after you’ve finished eating. You may experience:
Surgical causes include:
Disease-related causes include:
If you have a history of gastric surgery, even if it was years ago, your healthcare provider may be able to diagnose dumping syndrome based on your symptoms alone. They may give you a self-assessment questionnaire called the Dumping Symptom Rating Scale that scores your symptoms to determine how severe they are. They may also want to run tests to confirm the diagnosis or to rule out other possible causes of your symptoms. This is especially important if you don’t have a history of gastric surgery.
Tests to diagnose dumping syndrome include:
Most people can successfully manage dumping syndrome with dietary changes. When severe symptoms don’t respond to diet, medication may be an option. But medications can have side effects and aren’t ideal for long-term use. Rarely, when dumping syndrome results from surgery, and when all other treatments have failed, your healthcare provider might suggest another surgery to fix the problem.
Healthcare providers recommend following these general guidelines to reduce symptoms:
Certain medications can help modify the symptoms of early and late dumping syndrome, including:
Surgery is rarely recommended for dumping syndrome. But if surgery was the original cause of your distress, surgery again might undo it. When nothing else has helped and dumping syndrome is severely affecting your quality of life, you might choose to undergo reconstructive surgery. This usually means:
It usually does, over time. Milder cases of early dumping syndrome usually resolve within three months. More severe cases and late dumping syndrome may take 12 to 18 months to subside. In the meantime, dietary changes will usually help, though it may take several weeks before you notice improvement.
This diet can help modify or prevent symptoms of dumping syndrome, particularly after gastric surgery.
|Foods to include||Foods to avoid|
|Protein: eggs, meat, poultry, fish, nuts and nut butters, beans and legumes.||Sweets: cookies, candy, packaged breakfast cereals, sugary drinks and desserts.|
|Fats: butter, mayonnaise, salad dressings, avocados, oily fish, nuts and nut butters.||Dairy: milk, cream, yogurt and cheese (if they bother you).|
|Complex carbohydrates: unsweetened whole grain cereal, oatmeal, bread, rice and pasta.||Simple carbohydrates: white bread products, crackers and chips, fruit juices and sweeteners.|
|Soluble fiber: peas, beans, apples, oranges, carrots, broccoli and brussels sprouts.||Calorie-rich drinks: nutritional shakes and liquid nutritional supplements.|
|Foods to include|
|Protein: eggs, meat, poultry, fish, nuts and nut butters, beans and legumes.|
|Foods to avoid|
|Sweets: cookies, candy, packaged breakfast cereals, sugary drinks and desserts.|
|Fats: butter, mayonnaise, salad dressings, avocados, oily fish, nuts and nut butters.|
|Foods to avoid|
|Dairy: milk, cream, yogurt and cheese (if they bother you).|
|Complex carbohydrates: unsweetened whole grain cereal, oatmeal, bread, rice and pasta.|
|Foods to avoid|
|Simple carbohydrates: white bread products, crackers and chips, fruit juices and sweeteners.|
|Soluble fiber: peas, beans, apples, oranges, carrots, broccoli and brussels sprouts.|
|Foods to avoid|
|Calorie-rich drinks: nutritional shakes and liquid nutritional supplements.|
A note from Cleveland Clinic
Dumping syndrome is one of the most common post-gastrectomy syndromes that affect people recovering from surgery. There’s a good chance you may experience some symptoms immediately following your procedure. Fortunately, most cases are mild and go away on their own in a few weeks to months. In the meantime, you can usually manage the condition by adjusting your diet.
If you have an operation in your future, it’s a good idea to plan ahead for a dumping syndrome diet. Stock your kitchen and have some meal plans in mind. If you’ve made dietary adjustments, but they haven’t helped, contact your healthcare provider. They can prescribe medications to help get you through your recovery period.
Last reviewed by a Cleveland Clinic medical professional on 06/07/2022.
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