Dumping ..........Re-Post
Ok,
Just Another Re-Post………………
(Passing on for those just joining the Board recently…..)
(Ignore if you’ve seen it…..)
--------------------------------------------------------------------------
Dumping ..........
And here goes-
(yes, it just applies to those with RNY’s but hopefully useful for them)
“Everything you Ever/Never Wanted to Know About Dumping!” (& some)
It’s a combo of What I’ve been told,
What I’ve experienced and
Some of the Med-Speak Crap
From handouts from my Doc. At Support group.
(Remember, If you opt for DS or the Band
No dumping “per sea,” But, often
Some lactose intolerance and minor dumping like symptoms
Even with the DS.)
The weight loss that is achieved through the RNY
Appears to be somewhat dependent
On the removal of the Pyloric Valve, (the “sphincter” of the stomach)
Leaving the individual with a small stoma -
As the only regulator
Of food movement into the small intestine.
This can result in the phenomena called "Dumping Syndrome."
It can cause an individual to feel sick or even faint.
And by “sick,” I mean any thing from –
“I feel a little icky…” – to - “Please God, Let Me Die!!!”
Although many think the name would come from
“Taking a Dump” just with the Volume turned WAY UP!
The Slang term actually comes from the way food is “dumped”
Into the small intestine 10 to 15 minutes after eating,
Rather than being released gradually in small amounts
By the Pyloric Valve from the stomach into the small bowel.
This Rapid gastric emptying, or dumping syndrome,
Happens when the small intestine (jejunum portion)
Fills too quickly with undigested food from the stomach.
Now this is the part
That leads to so much confusion-
There is –
“Early Dumping”
And “Late Stage Dumping”
They are rather different.
And caused by different things.
"Early" dumping begins during
Or right after a meal.
Symptoms of early dumping may include –
Nausea, Vomiting, (resulting from that nausea)
Bloating, (Fast Gas Production)
And Diarrhea, (ranging from 
That best describes Mine.
Well, actually coupled with Late as well.
Some people have both types to a degree.
I’m lucky that way….
"Late Stage Dumping”
Happens 1 to 3 hours After eating.
Symptoms of late dumping include weakness,
Sweating, and dizziness.
Late dumping has to do with the blood sugar level.
The small bowel is very effective in absorbing sugar,
So that the rapid absorption of a relatively small
Amount of sugar can cause the glucose level in the blood
To "spike" upward.
The pancreas responds to this glucose challenge
By "cranking up" its output of insulin.
Unfortunately, the sugar that started the whole cycle
Was such a small amount that it does not sustain
The increase in blood glucose,
Which tends to fall back down at about the time
The insulin surge really gets going.
Yes?
So you feel like
Someone has given you an unnecessary
Shot of insulin.
It’s basically a bout of hypoglycemia (low blood sugar),
which causes you to feel weak, Super Sleepy, and completely fatigued.
Late Dumping has another Evil in its arsenal.
It is a way for gastric bypass patients to fall into a vicious cycle of eating.
If the patient takes in sugar
Or a food that is closely related to sugar
(simple carbohydrates like rice, pasta, potatoes)
They may experience a small degree of Hypoglycemia
In the hour or two after eating.
The hypoglycemia stimulates appetite,
You eat more, cycle repeats,…..
And it's easy to see where that is going....
Yes?
Some, who claim “bingeing” with Carbs
Have actually been riding like a surfer
On the front edge of a wave of hypoglycemia.
That requires some bravery and stupidity
In just the right balance, but does happen.
That “Emotional Eating,” Thing is a dozey!
The reason that sugar does not cause dumping
In non-operated people is that the stomach,
Pancreas, and liver work together to prepare nutrients
(Or sugar) before they reach the small intestine for absorption.
The stomach serves as a reservoir that releases food
Downstream only at a controlled rate, through the Pyloric Valve.
This avoids the sudden large influxes of sugar
That can occur after a RNY.
The released food is also mixed with stomach acid,
Bile, and pancreatic juice to control the chemical makeup
Of the stuff that goes downstream
And avoid all of these effects above.
For Late Dumping –
Lying down immediately after eating reduces the symptoms
Because gravity isn’t draining the stuff straight into
Your intestines. Yes?
It may give you just a serious nap.
Now,
One more Intricacy that makes it so
Difficult to pin down –
“Dumping Syndrome-Do I have it or Not?”
Is-
Lactose Intolerance.
The symptoms of this are typically
Gas, medium to extreme,
Diarrhea, medium to extreme,
And most all of the symptoms of dumping syndrome
Except the Blood Sugar drop
Seen in Late Dumping.
Since Bypassing some of the small intestine,
(That portion where typically the milk sugar Lactose
Would be processed,)
The milk sugars may also create small
Amounts of Dumping syndrome on there own.
Many Bypass patients who do not have the big reaction to
Sugar in the form of Dumping Syndrome will
Experience the typical Lactose intolerance symptoms
That some Non- Bypass people have.
The Lactose in milk, has been eaten or processed
By bacteria mostly in Yogurts, and Cheeses
Which is why those don’t cause problems.
Some will also have Dumping-Like Symptoms resulting from
Foods with high fat content.
More like severe indigestion with diarrhea rather
Than full out Dumping.
This is due to not mixing with bile
Soon enough in the system.
This is one of the reasons
For the 38% malabsorption of Fats in RNY people
And the 81% malabsorption of Fats in DS people.
In Both, the extra unabsorbed fats,
(If in high enough concentration,)
Tend to cause them to Poop like a Goose!
So for both, particularly
The RNY folks who still get calories from a lot of that fat,
Best To keep those fat percentages under control to keep
The Poo Normal. Yes?
Many, myself included,
Consider dumping syndrome
To be a beneficial effect of gastric bypass.
Freaky at that seems to some,
It provides quick and reliable negative feedback
For intake of the "wrong" foods.
In practice, most patients DO NOT
Experience full-blown dumping
More than once or twice.
Most simply say that they have
"Lost their Taste" for sweets.
Some, have Dumping Syndrome early on,
But as their system adapts to the new
“Goings On,” they lose it,
And their Digestive system compensates.
Others, like myself, have it for life.
(or at least it’s still going strong at nearly year 3)
There are some people who have had no reaction
To sugars and then One Day- POW!
Full Blown Dump!
Something about the food they ate,
And the speed that in went into
The intestines, set them off.
This happens sometimes
Due to drinking with a high osmolarity food.
Speed into the Intestine
Plus
Molecular Density Of the thing entering,
Equals “Degree of Dumping Syndrome Effect.”
Yes?
Now,
All that sounds bad.
But, It can all be avoided-
JUST Don’t Eat Sweets!
And High Carb/Sweet mix foods!
Or-
The General Guidelines
For avoiding/reducing Dumping Syndrome
(From a handout at my support group
From a Nutritionist who works with Bypass folk.)
1.) Avoid taking liquids with meals.
Liquids should be taken 30 minutes before or after meals
And limited to ½ to 1 cup servings.
Carbonated beverages are not recommended
In the initial stages of the diet to prevent excess gas formation.
2.) Small, frequent feeding should be provided.
The number of feedings depends on the patient’s tolerance
To specific portions of food.
Foods should be eaten slowly and chewed well.
Avoid those known to cause individual problems.
3.) The diet should be low in simple carbohydrates,
High in complex carbohydrates and protein,
And moderate in fat
With the purpose of achieving and maintaining
The optimal weight and nutritional status of the patient.
4.) All food and drink should be moderate in temperature.
Some patients tolerate warm water
Better than iced or cold water.
5.) Avoid foods that are natural laxatives,
Such as figs, prunes, and licorice.
6.) If “dumping” is a problem,
It may be helpful to lie down
20 to 30 minutes after meals and even up to an hour
To retard transit to the small bowel.
7.) Slowly introduce small amounts of milk into the diet
To determine tolerance.
If milk products are tolerated,
They can play a key role
In providing an easily tolerated protein
And other nutrients such as calcium and vitamin D.
Trick/Tip from my Doc- (useful for Diabetics as well)
Pectin,
A dietary fiber found in fruits and vegetables,
May be helpful for treating dumping syndrome
And even simple diarrhea.
Pectin delays gastric emptying,
Slows carbohydrate absorption,
And reduces the glycemic response.
1 tsp pectin powder 3 times daily may be effective.
(It’s that “Sure-Jell” stuff for making
Home-made Jelly. Great food additive)
So,
That’s the –
“Everything and then some I know about Dumping.”
Best Wishes-
Dx
Capricious; Impulsive, Semi-Predictable 
