Question:
I think that I dumped this morning!

I have had a very easy time with the gastric bypass surgery recovery,I can eat most everything in small quantities! Something odd happened this morning and I can't quite figure it out. I ate some spicy salsa and tortilla chips right before I went to bed last night with a glass of milk,I was fine until I woke up at 5:30am for work.I had terrible diarrea and passed out in the bathroom,I was so dizzy and sick that I thought I was gonna die! I went back to bed and slept until 200pm and am much better now.My question is, could this be a delayed dumping situation or just a reaction to the salsa?I am gonna be much more careful with what I eat from now on,obviously!!I thought salsa would be good for me, but it was spicy!!    — natalie J. (posted on March 4, 2004)

March 4, 2004
I could be wrong, but I would be surprised if that was dumping.... Could you have a food poisoning or intestinal virus? here is an article I found a while ago on dumping. The Physiology of Dumping Syndrome Dumping syndrome is usually divided into "early" and "late" phases - the two phases have separate physiologic causes and will be described separately. In practical fact, a patient usually experiences a combination of these events and there is no clear-cut division between them. Early dumping is caused by the high osmolarity of simple carbohydrates in the bowel. The various types of sugar all have small molecules, so that a gram of (for example) sucrose has MANY more molecules than a gram of protein, creating a higher concentration (number of molecules per cc) from simple sugars than from other foods. This matters because, inside the body, fluid shifts will generally go toward the higher concentration of molecules. So, if a patient consumes a bite of milk chocolate (lots of sugar), when it gets to the Roux limb it will quickly "suck" a significant amount of fluid into the bowel. This rapid filling of the small bowel causes it to be stretched (which causes cramping pain). This also causes the activation of hormonal and nerve responses that cause the heart to race (palpitations) and cause the individual to become clammy and sweaty. Vomiting or diarrhea may follow as the intestine tries to quickly rid itself of this "irritant." 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. These factors combine to produce hypoglycemia (low blood sugar) which causes the individual to feel weak, sleepy, and profoundly fatigued. Late dumping is the mechanism by which sugar intake can create low blood sugar, and it is also a way for gastric bypass patients to get 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 will experience some degree of hypoglycemia in the hour or two after eating. The hypoglycemia stimulates appetite, and it's easy to see where that is going.... 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, avoiding sudden large influxes of sugar that can occur after a Roux-en-Y. 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 the effects outlined above. Obviously, surgeons consider dumping syndrome to be a beneficial effect of gastric bypass - it seems to be important to provide 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. Of course, this is always a great topic to ask patients about directly, so you may want to ask about it at our support group in person, or in a support group online. This page was last updated on:
   — **willow**

March 4, 2004
If it was me...I would be questioning the milk. I get sick from it now...combination of the milk sugar in it and the lactose.
   — jennifer A.

March 4, 2004
I think it definately could be dumping. I've had delayed-dumping like that before where I will get diarhea and dizziness hours after I ate the culprit. I've also had bouts with my sugar crashing and making me literally unable to get out of bed in the morning....all because I ate something too sugary before I went to bed. As long as you feel ok now, I wouldn't worry though.
   — emilyfink

March 4, 2004
Dumping happens within 30 minutes of eating. That food just didn't agree with you.
   — mrsmyranow

March 4, 2004
Isnt it a life long situation that we can NOT drink and eat at the same time? Hope you feel better.
   — Kathy S.

March 5, 2004
Yep, I'd be willing to bet on the milk, too. There's a lot of sugar in milk, and there's also lactose (unless you're drinking Lactaid milk).
   — Leslie F.

March 5, 2004
Sounds like you dumped on the milk to me. I dump on milk and yogurt and even Lactade. Look at the sugar grams in milk (yogurts and Lactade too). Anything over 10 grams (sometimes even less) I dump on it. ~Sidney~ Open RNY 10-23-02 down 130+ and below goal
   — Siddy I.

March 5, 2004
Natalie what is strange is something that your stomach found tolerable today could make you sick a day or month later. I ate salsa a few weeks ago no problem, but if I had it today it might make me sick. It is best to introduce new foods by themselves or with known foods bearing in mind that each time could be a different experience. GOOD LUCK on your journey!
   — Anna M.