Dumping syndrome can occur in up to 50 percent of postgastric bypass patients when high levels of simple carbohydrates are ingested . Dumping may contribute to weight loss
in part by causing the patient to modify his/her eating habits.
There are two types of dumping syndrome: early and late.
Early dumping syndrome — Early dumping syndrome has a rapid onset, usually within 15 minutes. It is the result of rapid emptying of food into the small bowel. Due to the hyperosmolality of the food, rapid fluid shifts from the plasma into the bowel occur, resulting in hypotension
and a sympathetic nervous system
response. Patients often present with colicky abdominal pain
, diarrhea, nausea, and tachycardia.
Patients should avoid foods that are high in simple sugar content and replace them with a diet consisting of high fiber, complex carbohydrate, and protein rich foods. Behavioral modification, such as small, frequent meals, and separating solids from liquid intake by 30 minutes, are also advocated. Usually, early dumping is self-limiting and resolves within 7 to 12 weeks
Late dumping syndrome
— Late dumping syndrome is a result of the hyperglycemia
and the subsequent insulin response leading to hypoglycemia
that occurs 2 to 3 hours after a meal. Patients present with dizziness, fatigue, diaphoresis and weakness. The treatment is similar to early dumping syndrome.
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