Dumping Syndrome: Causes, Symptoms, Treatment and Cost

Dumping Syndrome is a medical condition that is characterised by the rapid movement of food from the stomach into the small intestine. Dumping Syndrome is most commonly seen in people who have had surgery on their gastrointestinal tract or who have diabetes.

Early dumping syndrome and late dumping syndrome are the two primary subtypes that fall under the umbrella term 'dumping syndrome.'

• Early Dumping Syndrome: Early dumping syndrome usually occurs within 10 to 30 minutes after eating, and is caused by the body releasing too much insulin in response to a high intake of simple carbohydrates such as sugar, honey, syrups, and processed foods like white bread and pasta.
• Late Dumping Syndrome: Late dumping occurs about one to three hours after eating a meal rich in carbohydrates or sugar. This type of dumping syndrome is caused by the rapid movement of glucose into the bloodstream from the small intestine which in turn causes an overproduction of insulin from the pancreas leading to hypoglycemia (low blood sugar).

Dumping Syndrome can be caused by:

• Gastric surgery, such as gastric bypass surgery or other gastrointestinal surgeries, in which part or all of the stomach is removed or bypassed.
• Conditions that affect normal gastrointestinal motility, such as diabetes, scleroderma, and Parkinson’s disease.
• Disruption in the normal balance of hormones that regulate digestion and absorption of food in the intestines.

The following are examples of symptoms of dumping syndrome:

• Abdominal cramps, pain, and discomfort.
• Diarrhoea
• Nausea and vomiting
• Weakness or dizziness
• Sweating or flushing of the skin.
• Rapid heart rate and palpitations.
• Low blood sugar (hypoglycemia).

• Consume a series of smaller meals throughout the day rather than three or four large ones.
• Chew food thoroughly before swallowing it and eat slowly to aid digestion.
• Avoid drinking fluids with meals and wait at least 30 minutes after eating before drinking anything.
• After eating, maintaining an upright position for as least an hour will assist your stomach in effectively emptying itself.
• Ask your physician or a dietitian about medications that can help control the release of sugar into the intestine and reduce symptoms of dumping syndrome.

Diagnosing Dumping Syndrome can be difficult because its symptoms may be similar to other conditions and diagnosis can be done by using the techniques given below:

• Review of medical history and physical examination: The medical history typically includes questions about diet, medications, and any symptoms that may be related to the condition. The physical examination may include checking the abdomen for signs of abdominal distension or tenderness.
• Blood tests: They are also used to measure levels of glucose, insulin and other hormones in the body that may indicate a problem with digestion or absorption of food.Ultrasound or CT scans : Imaging tests such as ultrasound or CT scans may also be used to look for any blockage or narrowing of the gastrointestinal tract that could contribute to the symptoms of Dumping Syndrome.
• Endoscopy: Endoscopy is sometimes recommended where an instrument is inserted through the mouth into the stomach for visual inspection of any abnormalities that could contribute to Dumping Syndrome.
• Barium studies: Barium studies are tests that involve drinking a solution containing barium, a type of metal. The barium is then visible on X-ray images and can be used to examine the upper digestive tract for signs of dumping syndrome. This test can help diagnose the condition and help plan treatment.

• Nutritional Deficiencies: Dumping Syndrome can lead to nutritional deficiencies due to the rapid absorption of sugars and other nutrients into the bloodstream. This can cause deficiencies in iron, calcium, and other essential vitamins and minerals.
• Dehydration: As a result of the body's increased need for fluids to process the large influx of sugars, dehydration can be a complication of Dumping Syndrome.
• Low Blood Pressure: With the sudden influx of sugar in the bloodstream, individuals with Dumping Syndrome often experience a drop in blood pressure that can lead to feelings of lightheadedness or dizziness.
• Abdominal Pain and Diarrhoea: Abdominal pain and diarrhoea are common symptoms experienced by individuals with Dumping Syndrome as a result of the rapid digestion process.
• Heart Palpitations: The sudden influx of sugar into the body can cause an increased heart rate which leads to heart palpitations or an irregular heartbeat in some cases.

• Ginger: Ginger has anti-inflammatory properties and helps in digestion. It also helps settle an upset stomach, reduce nausea and vomiting, and ease bloating.
• Fennel: Fennel is helpful in relieving the symptoms of dumping syndrome such as nausea, vomiting, cramps, bloating and gas.
• Licorice Root: Licorice root is known to help with digestive problems such as dumping syndrome by increasing bile production in the liver and reducing inflammation of the digestive tract walls.
• Marshmallow Root: Marshmallow root helps soothe irritated tissue that can be caused by dumping syndrome by forming a protective layer over them that reduces inflammation and aids digestion.
• Turmeric: Turmeric has powerful anti-inflammatory properties which can help reduce symptoms associated with dumping syndrome such as abdominal pain, cramps, nausea and vomiting.

Choose complex carbohydrates, such as whole grain breads and cereals, brown rice, oatmeal, quinoa, legumes and starchy vegetables like sweet potatoes and squash.

Consume lean proteins like fish, poultry, beans or tofu at each meal or snack.

• Sugary foods and drinks: Avoid sugary beverages, sweets, and desserts that are high in sugar.
• High-fat foods: Limit or avoid fried foods, fatty meats, whole milk products, and butter or margarine.
• Caffeine: Avoid coffee, tea, cola drinks, chocolate and other caffeine-containing foods and beverages.
• Alcohol: Avoid alcohol consumption.
• Carbonated beverages: Avoid carbonated drinks such as soda pop because they can cause gas in the stomach and intestines which may worsen symptoms of dumping syndrome.

Treatment for dumping syndrome includes dietary changes, medication to slow down digestion and absorption of food, and surgery if necessary.

• Dietary Changes: The most important part of treating dumping syndrome is making dietary changes that reduce the amount of sugar in your diet. Additionally, eating protein-rich foods such as eggs or nuts before eating carbohydrates can help slow down digestion and absorption of sugars.
• Gastric Surgery: This is the most common surgical treatment for dumping syndrome and involves either reducing the size of the stomach or rerouting parts of the small intestine to slow down digestion.
• Endoscopic Procedures: Endoscopic procedures such as endoluminal gastroplication can be used to decrease gastric emptying and reduce symptoms of dumping syndrome.
• Intestinal Bypass Surgery: This type of surgery involves bypassing part of the small intestine in order to reduce the amount of food that is absorbed, thus reducing symptoms associated with dumping syndrome.

A gastroenterologist or a dietitian should be consulted for diagnosing and treating dumping syndrome.

• Proton pump inhibitors (PPIs): PPIs can help reduce the amount of acid in your stomach and slow down digestion so that food passes through more slowly and symptoms can be relieved.
• Somatostatin analogs: Somatostatin analogs, such as octreotide and lanreotide, can help reduce symptoms of diarrhoea and other gastrointestinal issues associated with dumping syndrome.
• Acarbose: Acarbose is a medication that helps to slow down digestion and improve nutrient absorption in people with dumping syndrome.
• Other medications: Medications that slow down the movement of food from the stomach to the small intestine, such as erythromycin or metoclopramide, can also be helpful in managing dumping syndrome.

Dumping Syndrome typically takes 3-4 weeks to recover from.On the other hand, a complete recovery may take as long as six months.

The severity of the symptoms and the time taken for recovery depend on the underlying cause of the syndrome, as well as how quickly treatment is sought after identifying the symptoms.

The results of treatment for dumping syndrome are not permanent and the symptoms can come back at any time. Additional therapy could be required in the event that the underlying cause is not addressed or if the problem keeps coming back.

These guidelines are designed to help you manage your symptoms and prevent complications.

• Eat small meals more frequently throughout the day: Eating smaller meals more frequently throughout the day will help keep blood sugar levels stable and reduce the risk of developing dumping syndrome related symptoms. In addition to eating small meals every four hours, it should also be noted that eating too quickly can also trigger dumping syndrome symptoms such as abdominal cramps and bloating.
• Eat a balanced diet: Eating a balanced diet will ensure that you get all of the nutrients you need while avoiding foods that may trigger your dumping syndrome related symptoms such as sugary and high-fat foods mentioned above.
• Drink plenty of fluids: To help prevent dehydration it is important to drink at least 8 glasses (2 litres) of water each day as this will aid in digestion.
• Exercise regularly: Regular exercise helps improve circulation throughout your body which helps reduce any associated heartburn or indigestion caused by eating too quickly or consuming sugary or high fat food items.
• Monitor for signs/symptoms: It is important to monitor for any signs/symptoms associated with Dumping Syndrome such as nausea/vomiting, abdominal cramping/pain, lightheadedness/dizziness etc., so if these should occur seek medical advice immediately.

The cost of treatment for Dumping Syndrome in India will vary depending on the severity of the condition, the type of treatment needed, and the location of the medical facility.

Generally, treatments for Dumping Syndrome can range from a few hundred to several thousand rupees.

Common side effects of dumping treatments include:

• Nausea
• Abdominal cramping and pain
• Diarrhoea
• Flushing
• Rapid heartbeat
• Sweating
• Weakness or dizziness

If you are suffering from any complications relating to dumping syndrome then you should consult a doctor nearby as they can cause complications like nutritional Deficiencies, dehydration, heart palpitations, etc. in which treatment courses can range from a few months to years depending on the severity of the situation.