Dumping SYndrome
Dumping syndrome is a condition that can occur after bariatric surgery, particularly following gastric bypass. It is characterized by rapid gastric emptying, where food moves too quickly from the stomach to the small intestine. This rapid transit can cause a range of symptoms, including nausea, abdominal cramping, dizziness, and fatigue. Dumping syndrome affects approximately 15-30% of gastric bypass patients, though the incidence can vary based on individual factors and post-surgical habits.
Where does it come from?
The main cause of dumping syndrome is the altered anatomy following surgery, where the pyloric valve (responsible for controlling stomach emptying) is bypassed or altered. This can lead to rapid shifts in fluid and insulin levels, causing both early and late dumping symptoms.
Early vs. Late Dumping Syndrome
Early Dumping: Symptoms typically occur 10-30 minutes after eating. They include abdominal pain, bloating, nausea, diarrhea, and a rapid heart rate. Early dumping results from a large volume of food quickly moving into the intestine, causing fluid shifts and blood pressure changes.
​
Late Dumping: Symptoms appear 1-3 hours after eating and are often related to a spike in insulin, which can lead to low blood sugar (hypoglycemia). Symptoms include dizziness, fatigue, weakness, sweating, and shaking.
Eating Habits and Conditions Contributing to Dumping
Certain dietary choices and eating habits can contribute to the onset or worsening of dumping symptoms:
High Sugar Intake: Sugary foods and drinks can trigger a sudden influx of glucose in the small intestine, leading to a rapid insulin response and subsequent symptoms.
Large Meal Portions: Eating large meals can increase the volume of food entering the intestines quickly, exacerbating symptoms.
Lack of Protein and Fiber: Meals lacking in protein and fiber may empty more rapidly from the stomach, which contributes to dumping.
Liquid Intake with Meals: Drinking fluids with meals can increase the speed of stomach emptying, worsening dumping symptoms.
Lifestyle Changes to Help Improve Dumping Syndrome
Small, Frequent Meals: Eating smaller portions more frequently can reduce the volume of food entering the intestine at one time, minimizing symptoms.
Focus on Protein and Fiber: Including protein and fiber-rich foods helps slow gastric emptying and reduce blood sugar spikes.
Avoid Sugary Foods: Minimize or avoid foods high in sugar to prevent rapid glucose absorption and insulin spikes.
Avoid Drinking Liquids with Meals: Drink fluids between meals rather than during, to slow the emptying process.
Medical Management
Acarbose: This medication slows the digestion of carbohydrates, helping prevent the rapid glucose rise associated with late dumping.
Octreotide: In severe cases, this injectable medication can help slow gastric emptying.
Proton Pump Inhibitors (PPIs): Though primarily used for acid reflux, PPIs may be beneficial for some dumping patients by reducing acid output and possibly affecting the rate of gastric emptying.
TORe
Procedure
The Transoral Outlet Reduction (TORe) procedure is an innovative endoscopic technique designed to reduce the size of the stomach outlet in gastric bypass patients. By decreasing the outlet’s diameter, TORe slows the rate at which food exits the stomach pouch, thereby reducing symptoms of dumping syndrome. Research studies have shown that TORe can help improve both early and late dumping symptoms, with many patients experiencing significant symptom relief. This procedure is also utilized to help with weight regain after gastric bypass.
The TORe is a fantastic non-invasive, endoscopic tool to treat Dumping Syndrome and Weight Regain after gastric bypass!
​
Many patients report improved quality of life and reduced symptoms after undergoing TORe.