Dumping and malabsorption with the sleeve

I attended Support Group meeting on Saturday.  The surgeon speaking said that although it isn't common, that some Sleevers do dump and she also said that there is some malabsorption with the sleeve, but not severe. 

This is the first time I have heard either of these statements.  Thoughts? 

I've experienced something like dumping when I've eaten something too high in sugar / carbs, especially if I've eaten it too quickly. I wonder if it isn't that my body has adjusted to a more stable blood sugar level, so if I do something that causes a big spike, it really makes me feel ill.
As far as malabsorption goes, I suppose it depends on exactly what they mean is being malabsorbed. For example, we need to supplement with B-12 and calcium citrate (because we lack the stomach acid to absorb calcium carbonate effectively), and often iron and vitamin D.

I have experienced the same thing.  I hesitated to call it dumping, because I keep reading that people who have had VSG don't dump.  So I just assumed it was a blood sugar thing going on, but that may be what dumping is too.  I guess I have never looked into the dumping syndrome to see if it's  the body's reaction to sugar or something else.  

I've always held the assumption that the reason we need to take supplements is because we can't eat enough foods to get the necessary vitamins. 

Guess I learn something new all the time! 

Reactive hypoglycemia or "dumping" can occur with the sleeve. When I had my year visit with the Bariatric Internist, I asked her about this, since I had read some postings regarding this reaction. She said that she had just returned from a Bariatric Conference and RH can occur with sleeve patients, probably due to the increased gastric emptying. She said that she had confirmed 3 cases through medical testing in her own practice.

As far as "malabsorption" I don't know about this, but I would think, that due to the decrease surface area for absorption and decreased intake, not all nutrients are absorbed sufficiently, which is why we need to supplement with calcium, B-12, and iron. At my pre-op visit, the surgeon said the nutrient deficiencies do occur with the sleeve, but they can be corrected more rapidly than with the malabsorptive surgeries.

Another good reason to always have protein with meals and snacks. Simple carbs will cause the RH and dumping.

Hope this helps.

Gail

That explains why I have had the awful feeling after eating sweets. I assumed it was a blood sugar drop.  I have never looked into the dynamics of "dumping", so I didn't realize it was a hyopglycemic response. 

The doctor did suggest that the malabsorption was due to the size of the stomach and how the food goes to the intestines more quickly than with a normal sized stomach, but the malabsorption was minimal.  She also stressed this as being a good reason for us sleevers to continue with our supplements. 

 I've experienced dumping and often heard of it.  What many people don't realize is that none altered people dump.  It has to do with how quickly food often not throughly digested food enters the intestines.  It has to do with quick gastric emptying or stomach emptying or something like that.

Personally I also have an issue with my vitamin A, D, & Iron absorption.

Ms Shell

This is true. I used to "dump" pre-op, if I ate too much fat or sugary food. It can happen with just about anyone, although, it may be more common with the malabsorptive surgeries.

gail

Anyone can dump, even people without WLS. But it's really, really rare and a lot of what sleeve people call dumping is often just their sleeve being picky in the early days or the beginnings of a disseased gallbladder.

I think it's really common for WLSer to call any thing bad that happens when they eat, dumping. I ran into a RnYer who was calling it dumping whenver she got the foamies! 

And the speaker is wrong about the malabsorption. We can experience maldisgestion but that's different -- it involves breaking stuff down in the tummy and can be fixed by chewing better and taking enzymes with our food. But our intestines absorb everything we put in them.

So, perhaps more to the point, is there reason to believe the job of maintaining will change substantially for us down the road?  I know for RNYers, the malabsorption of calories eventually disappears, hence a tendency to regain some.  But for us, aside from the normal changes that go with aging / menopause, shouldn't we be fairly stable once we hit maintenance?  If we continue to maintain the same caloric intake and exercise (and I do realize that's a big IF, and the key to success), is there reason to think we'll still be fighting mysterious regain in 5 years?

Good point.  I sure hope we don't have enough malabsorption that it would work against us in maintenance.   I still keep wondering when my body is going to realize it is 60 years old and then my metabolism starts to slow down.  I don't think it has adjusted to "normal" yet and I worry about when it does.  So, I'll keep exercising daily and hope that it keeps regain from happening - along with better eating habits.  But boy, oh boy, those eating habits are sometimes hard to control.