Question for the sleeve peeps - any of you have dumping after being sleeved?

After VSG food does not bypass the duodenum and dump directly into the small intestine. The intestines are not bypassed at all.

Dumping that occurs with RNY cannot occur with VSG no matter how many people believe that it is happening to them.

Yes, I'm sure the doctors are wrong. That must be it.

Four times you have responded on the VSG forum to my question to people who have had the sleeve to say "dumping that occurs with RNY cannot occur with VSG". You had RNY.

I'm going to tell you that you are wrong and back it up with facts and credentials:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875983/

Are you trying to say VSG dumping is different than RNY dumping?

I would say the mechanism that causes it is different. Research shows that dumping syndrome existed long before RNY. Folks experiencing dumping syndrome after Bariatric surgery are just joining them. Either way, dumping is different for everyone and can be different each time for the individual experiencing it.

I think it's offensive to say to people who have dumping syndrome without an RNY that they are not experiencing what they are experiencing but that they just "believe" it.

Either you are sweating, or you are not.

Either your heart is racing, or it is not.

Either you are bloated or you are not.

and on, and on (shaking, syncope, nausea, diarrhea, etc) . Belief is not a factor. The physical signs are present despite belief.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875983/

"two prospective studies reported that up to 40% of patients had symptoms suggestive of dumping syndrome 6-12 months after sleeve gastrectomy"

Tzovaras G., Papamargaritis D., Sioka E., et al. Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy. Obesity Surgery. 2012;22(1):23-28. doi: 10.1007/s11695-011-0461-7. [PubMed] [Cross Ref]

Papamargaritis D., Koukoulis G., Sioka E., et al. Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obesity Surgery. 2012;22(10):1600-1606. doi: 10.1007/s11695-012-0711-3. [PubMed] [Cross Ref]

I dare say, you can't back up your statement "dumping that occurs with RNY cannot occur with VSG" with actual research, facts, or credentials.

Do you remember the nah nah nah days when we were stupid for not keeping our pyloric valve? Dumping = stupid? It was THE selling point for VSG and DS and here we are ...

And it turns out more and more are coming down with horrible gerd -- because they have their pyloric valve.

Dumb question. What is dumping? That oh no I need a bathroom fast combined with that hot feeling in your lowe abdomen? I thought it was throwing up combined with a hot flash.

https://www.urmc.rochester.edu/encyclopedia/content.aspx?Con tentTypeID=134&ContentID=107

This describes it pretty good....

Anyone can dump whether they've had WLS or not. I've definitely experienced it a few times in my life both pre and post-op. It sucks.

Having been there when my RNY friends dump, I can say what I experience isn't the same thing. But there are similar features. If I eat too much of certain foods, or ANY of some foods, I will start feeling absolutely horrible. I flush, get a racing heartbeat, and get nauseated to beat the band. I will have stomach cramps and feel like I'm coming down with food poisoning. Because I despise throwing up, I will manage to not do it most times, and just live with the nausea until the whole thing calms down, usually about 20 minutes. I don't get the diarrhea or any other symptoms of dumping. So I say I "mini-dump" because I've seen the full blown thing with friends.

Many people experience gastric dumping syndrome, and many are not WLS patients. Many things can cause it, such as medications, physiology, etc.

Dumping is the result of large amounts of sugar (carbohydrate) being in the intestines. Why? Consider that carbohydrate is very osmolar - this means that it's super easily absorbed. In fact, unlike protein and fat which must be absorbed in very specific parts of the guts areas, carbohydrate is absorbed as long as there are intestines in contact with it. This is why surgeries that drastically shorten the small intestine (like the DS) are the only ones that eliminate some of the digestible carbs, but why those of us with just a VSG or RNY still absorb them. This is also why carbohydrate can cause severe regain in many people who still have malabsorption, but protein and fat typically do not.

At any rate, it is a critical situation if there is a great deal of carbohydrate in the intestines, as they both expand to accomodate the volume, and the transfer of glucose and carbohydrate into the bloodstream begins. In order to process it, they pull in water from the bloodstream. This causes the total blood volume to drop, which causes dumping. A large number of people with dumping syndrome also have reactive hypoglycemia, as well.

VSG patients are less likely to experience dumping because of the pyloric valve, but also because we have substantially less ghrelin for quite some time. Ghrelin also is a trigger for gastric motility. This is why "protein first" minimizes the likelihood of it occurring. Serum ghrelin levels for RNY patients plateau and then eventually rise to normal. VSG patients maintain a deficit for longer. Less ghrelin = slower stomach emptying = less change of dumping.

My personal theories about WLS dumping:

1) Many people mistake reactive hypoglycemia for dumping syndrome. I feel RH is far more common in bariatric patients than is typically observed or acknowledged by doctors.

2) The VSG also has a metabolic alteration, though not as drastic, as the RNY, so it may still "overcorrect" some insulin resistance. People who have less damage to their metabolisms may experience it for a time.

3) patients who do not continue to eat slowly are more likely to experience dumping, particularly after resuming higher carb diets. This is because the large amount of additional food displaces what is in the stomach, pushing it forward and causing dumping.