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Pasadena, CA 91105

Dumping Syndrome

Dumping syndrome includes a series of symptoms that may occur minutes to hour(s) after certain types of meal(s) in patients that have had the gastric bypass operation. These symptoms may include nausea, vomiting, abdominal pain, high heart rate, dizziness and lightheadedness. In extreme cases some patients may actually experience confusion and syncope (fainting).

Dumping syndrome can be categorized to early and late dumping syndrome.

The underlying cause of dumping syndrome has to do with the passage of the inadequately processed, prepared food by the stomach into the small bowel. The uncontrolled passage of food to the small bowel can cause a rapid surge in blood sugar level which can cause an equally rapid rise in blood insulin level. The end result of this is very low blood sugar and the clinical sequela outlined above.

Another possible explanation is passage of food that can cause a fluid shift from the wall of the small bowel into the lumen of the small bowel. This is the possible cause of the gastrointestinal symptoms associated with the dumping syndrome.

Dumping syndrome is also associated with other non weight loss surgical procedure(s) of the stomach that exclude the pyloric valve. Examples of these are gastrectomies performed for gastric cancer, and non-healing ulcers of the stomach. The dumping syndrome is also noted to be more common in female than male patients. In post gastric bypass patients the diagnoses of dumping syndrome is usually made with a detailed history. There are cases where evaluation of the blood sugar will also confirm the suspected diagnosis of dumping syndrome.

The medical treatment of dumping syndrome after gastric bypass operation is very limited, and unsuccessful frequently. In a small percentage of patients the dumping syndrome is self-limiting. This means that over a period of time the symptoms of dumping syndrome become less severe and less frequent. In majority of these cases the only option is avoidance of any consumed food that brings on the symptoms of dumping syndrome.

One of the biggest misrepresentation of dumping syndrome following gastric bypass operation is that it protects against weight loss. I am not aware of any scientific evidence that demonstrates that patients with dumping syndrome have less chance of failure of the gastric bypass operation. Furthermore I am also unaware of any scientific evidence that shows that patient with dumping syndrome actually do better than those patients with no dumping syndrome after a gastric bypass operation. Dumping syndrome is a complication of the gastric bypass operation with no positive benefit for the patient when correlated to outcome of the gastric bypass operation. In fact there are patients who have significant hypoglycemic-dumping syndrome episodes after a gastric bypass operation, and this complication may become debilitating.

We have extensive experience in revision of gastric bypass operation to the duodenal switch to correct the complication of dumping syndrome and hypoglycemic episodes.

An Abnormal glucose tolerance test, resulting in hypoglycemic episodes (low blood sugar-which resolved in symptoms off dumping syndrome), has been widely discussed in peer reviewed journals. This is a link to such an article.