Dumping The Confusion About Dumping
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Dumping seems to be a topic that generates a lot of confusion. Some believe that everyone has dumping following gastric bypass surgery. Some may experience it and not recognize that it is dumping. Others believe that the presence or absence of dumping affects the potential success (or failure) of bypass surgery. Still others are so concerned about dumping that they avoid trying new foods or even eating healthy amounts of calories and Protein. So let’s see if we can dump the confusion about dumping.
Who Experiences Dumping
Estimates vary widely but somewhere between 15% to 50% of gastric bypass patients never experience dumping. It’s difficult to be exact because some experience dumping without realizing that their symptoms are the result of dumping. Others experience symptoms that they believe are the result of dumping when the cause is something else. Regardless of the exact number, a significant percentage of all gastric bypass patients never experience dumping.
What Causes Dumping
There are still some unanswered questions regarding the causes of dumping but it is generally thought to be the result of food being “dumped” too quickly from the pouch to the small intestine. Food high in sugar or simple carbohydrates (aka “simple sugars”) can create a rapid increase in blood sugars (hyperglycemia). The rule of thumb is that white foods (e.g. potatoes, rice, Pasta, white bread, etc.) are usually simple carbohydrates. The sugar in the small intestine rapidly pulls Water out of the bloodstream and into the small intestine. A number of the symptoms of dumping including severe diarrhea can result.
With “late” dumping (see below), the body responds to the rapid rise in blood sugars with an increase in insulin to process the sugars. The increased insulin can cause the blood sugars to “crash” producing hypoglycemia (low blood sugar) and dumping symptoms follow. Symptoms may or may not include vomiting. I have experienced late dumping on several occasions, usually after eating fruit, such as grapes, or white rice, both rich in sugars. In my case, symptoms are shakiness and general weakness but I have never had any vomiting.
What are the Symptoms
Just about everyone knows that dumping can cause vomiting. But all vomiting is not the result of dumping and all dumping does not cause vomiting. Symptoms of dumping include:
· Nausea or queasiness
· Profuse sweating
· General weakness
· Vomiting
· Shakiness
· Diarrhea
· Faintness
· Fatigue
· Heart palpitations (or increased heart rate)
Types of Dumping
Doctors divide dumping into two types and the symptoms may vary depending on which type you have:
· Early dumping – usually occurs within 15 to 30 minutes following the ingestion of certain foods. Roughly two-thirds of people who experience dumping have early dumping.
· Late dumping – usually occurs within one to three hours following the ingestion of certain foods. But it can occur as much as twelve hours after eating. About one-third of people who experience dumping have late dumping. Late dumping is linked with low blood sugar (hypoglycemia).
Success of Gastric Bypass and Dumping
There is no scientific evidence that patients who experience dumping are any more or less successful than patients who do not experience dumping. Dumping is not on the long list of factors that make gastric bypass surgery so effective for so many. So if you’re worried that your surgery might fail because you don’t have dumping, it just ain’t so!
Fear of Dumping
This is a good news, bad news kind of thing. If fear of dumping helps you to make better food choices, it’s a good thing. But if fear of dumping prevents you from eating a healthy number of calories and getting ALL of your protein requirement, it’s a bad thing. Remember the Prime Directive – the bypass surgery is a tool but the gold medal is lifestyle changes. Fear of dumping (or anything else) is not sustainable, it’s not compatible with living and enjoying your life, and it’s not a realistic expectation. Lifestyle changes are about control, not denial.
So How Do You Avoid Dumping
· Choose complex carbohydrates like whole grains instead of simple carbohydrates like white bread and sugary sweets.
· No liquids for 30 minutes before and 30 minutes after eating. Pretty much a standard recommendation for all bypass patients but especially important for avoiding dumping.
· Some people may not tolerate dairy products.
· Eat smaller meals more often.
· Keep a food diary to help you track your reaction to various foods. In addition to helping you avoid dumping, research has repeatedly shown that folks who maintain food logs lose more weight, lose it more quickly, and are more successful at maintaining their ideal weight.
· Incorporate high Fiber foods into your diet. Fiber takes longer to digest and extends the time the food takes to move from the pouch into the small intestine.
So there you have it. Dumping is not pleasant. But it’s often easy to avoid with dietary changes. Dumping does not always involve vomiting; there are a number of possible symptoms. A significant number of patients never experience dumping. And dumping has nothing to do with long term success or failure of gastric bypass.
Stay focused. Stay active. Stay away from the scales. You’re gonna love the new you!!