What Is Dumping Syndrome?

Dumping syndrome, otherwise known as rapid gastric emptying, is a condition that causes food to empty from the stomach and into the small bowel too rapidly after eating. It can lead to diarrhea, nausea, and abdominal cramping.

This article discusses the symptoms, causes, and treatment options for people with dumping syndrome. 

What Are the Symptoms of Dumping Syndrome?

Symptoms of dumping syndrome depend on the stage of the condition. There are two stages of dumping syndrome. The first, early dumping syndrome, presents with symptoms within 30 minutes of finishing a meal.

The second, late dumping syndrome, causes more symptoms to develop between one and three hours after eating. Late dumping syndrome is often referred to as post-bariatric hypoglycemia.

The symptoms involved in early dumping syndrome include:

• Diarrhea
• Bloating or feeling too full
• Nausea
• Abdominal pain and cramping
• Feeling or hearing rumbling in the stomach
• Feeling faint or lightheaded
• Needing to lie down
• Tiredness
• Redness in the face, neck, or upper chest (flushing)
• An increased or irregular heartbeat
• Sweating
• Headaches

After these symptoms pass, a person will develop late dumping syndrome symptoms. Some of them are the same as those that occur in the early stages and can include:

• Fainting or feeling lightheaded
• Feeling jittery or shaky
• Tiredness
• An irregular or rapid heartbeat
• Difficulty concentrating or focusing
• Sweating
• Weakness

What Causes Dumping Syndrome?

Dumping syndrome can develop because of surgeries, certain health disorders, and for no reason. Surgeries tied to dumping syndrome include: 

• Bariatric surgery, which is for extreme weight loss
• Surgery to remove part of the esophagus due to cancer or another health condition
• Fundoplication, which involves sewing the top of the stomach around the esophagus to treat hiatal hernias or gastroesophageal reflux disease (GERD)
• Gastrectomy, which partially or fully removes the stomach to treat peptic ulcers or stomach cancer
• Vagotomy, which reduces stomach acid by cutting the vagus nerve in the stomach

Health conditions that can drive dumping syndrome include:

• Newly acquired type 2 diabetes
• Exocrine pancreatic insufficiency
• Duodenal ulcers
• Zollinger-Ellison syndrome

In some cases, dumping syndrome can be idiopathic (appear without a known cause).

How Is Dumping Syndrome Diagnosed?

Diagnosing dumping syndrome involves a series of tests and examinations. To start the process, a healthcare provider will collect a review of your symptoms and medical history. They will likely ask if you’ve ever undergone bariatric surgery in the past.

When they have established that dumping syndrome is the possible cause of your symptoms, they will conduct several tests to confirm a diagnosis, such as: 

• Oral glucose tolerance test: Healthcare providers will ask you to fast for 10 hours to conduct this test. Then, they will give you a glucose solution to drink and monitor your blood sugar levels.
• Gastric emptying scan: To perform this test, a person must eat a bland meal that contains radioactive material. Medical providers will scan your stomach to watch how quickly the radioactive substance moves through your digestive tract.
• Upper gastrointestinal endoscopy or upper GI series: These tests look for structural abnormalities in the esophagus, stomach, and small intestine to rule out other possible conditions.

How Is Dumping Syndrome Treated?

There are three treatment approaches for dumping syndrome: diet changes, medication, and surgery. Healthcare providers will generally begin with diet changes and progress if there is no change in symptoms.

Diet

Healthcare providers will advise you to change your eating habits. The anti-dumping diet consists of: 

• Eating small portions more often throughout the day as opposed to having three large meals
• Eating slowly
• Chewing your food more thoroughly
• Always include lean protein sources and healthy fats in every meal
• Avoid processed foods and foods that are high in sugar
• Trying eating softer or pureed foods
• Eating foods high in soluble fiber and complex carbohydrates
• Drinking your water or beverage 30–60 minutes after or before eating

Medication

Certain medications can help to reduce the symptoms associated with dumping syndrome. The most widely taken are octreotide and acarbose. Octreotide can be taken in two forms: short- or long-acting. The short-acting form is taken two to four times daily before meals, and the long-acting form is a single injection every four weeks. Acarbose is mainly to help ease the symptoms of late dumping syndrome.  

Surgery

Typically, surgery for dumping syndrome is a last resort. It is reserved for:

• People with severe dumping syndrome
• People who did not respond to diet changes and medication
• Those whose dumping syndrome was caused by surgery

The surgeries involve reconstructing the stomach and gastrointestinal tract to control how fast food moves from the stomach and into the intestines. The surgeries often used for dumping syndrome include:

• Pyloric reconstruction
• Jejunal interposition
• Conversion of Billroth II to Billroth I anastomosis
• Roux-en-Y conversion

All surgeries are designed to stop the food from emptying into the stomach prematurely, and the type performed will depend on a person's case.

Summary

Dumping syndrome develops when food moves out of the stomach and into the small intestine too quickly. When a person develops the syndrome, they can experience many symptoms, including nausea, lightheadedness, and a rapid heartbeat. These symptoms are caused by low blood sugar, which occurs as a result of dumping syndrome.

Surgeries and health disorders can lead to dumping syndrome, but it can also develop out of nowhere and for seemingly no reason. To ensure proper treatment, your healthcare provider will run some tests and collect a symptom and health history from you.

When you have a definitive diagnosis, you can begin treatment. Therapy starts with a diet change and progresses to medication. Surgery may also apply in severe cases. Contact your healthcare provider if you experience any of the symptoms associated with dumping syndrome. With proper treatment, you can resolve it.