This study was posted on the Lap-band forum.  I am curious what the rest of you think about it. 

  Topic: The Sleeve is no longer considered a "Purely Restrictive Sugery" based on this...

Of course I am aware that this is a very small sample, but I would love to know your experiences.

I have had one experience since surgery that others here said was dumping. It was because I caved and ate sweets that my students brought in the last day of school, and it made me very very sick for about an hour and a half, and then I was fine.

Since then, I haven't had this happen, but then again I haven't tested the waters with sugary treats either, so I really couldn't say if it's an every time kind of thing for me or if my body was just not ready for that kind of food yet.

For the moment, I'd rather not find out

I have an exaggerated reaction to eating carbs now.  It does not seem as extreme to me as what dumping has been described as but it does make me a bit jittery and I am aware of a sugar high that was not there before surgery.  I am curious what others will come back with on this one.

 I don't have a dumping problem.  At times my constipation makes me wish that I did... it would ease the problem.  

On the carb note, the only problem they give me is that they seem to feed into my severe head hunger for a day or two.  

Yes.  I definitely dump.  The degree of dumping varies based on how much sugar the food I consume contains, as well as whether I eat it with, or in close proximity to protein. 

I don't throw up, but I do feel very sick.

Have you done any research into the long term effects of dumping?  I would love to know how it is connected, if at all to hypoglycemia that is seen in RNY patients down the road, or any other research you might have on this.  I am hoping that all of our resident VSG nerds will chime in here shortly. 

Lifted the following definition of Dumping Syndrome from WEBMD. Might help some answer the question posed. Having read the information below, I do not believe I 'dump'. I think I may be somewhat carb/sugar sensitive, but no more so than before VSG.

Dumping syndrome is common after gastric surgery. It is a group of symptoms that may result from having part of your stomach removed or other surgery involving the stomach. The symptoms range from mild to severe and often subside with time. Although you may find dumping syndrome alarming at first, it is not life threatening. You can control it by making changes in what and how you eat. By controlling dumping syndrome, you will also be avoiding the foods that tend to make you gain weight.

Causes of Dumping Syndrome

After gastric surgery, it can be more difficult to regulate movement of food, which dumps too quickly into the small intestine. Eating certain foods makes dumping syndrome more likely. For example, refined sugars rapidly absorb water from the body, causing symptoms. Symptoms may also occur after eating dairy products and certain fats or fried foods.

Dumping Syndrome: Symptoms of the Early Phase

An early dumping phase may occur about 30 to 60 minutes after you eat. Symptoms can last about an hour and may include:

• A feeling of fullness, even after eating just a small amount
• Abdominal cramping or pain
• Nausea or vomiting
• Severe diarrhea
• Sweating, flushing, or light-headedness
• Rapid heartbeat

 

Dumping Syndrome: Causes of the Early Phase

Symptoms of an early phase occur because food is rapidly "dumping" into the small intestine. This may be due to factors such as these:

• The small intestine stretches.
• Water pulled out of the bloodstream moves into the small intestine.
• Hormones released from the small intestine into the bloodstream affect blood pressure.

 

Dumping Syndrome: Symptoms of the Late Phase

A late dumping phase may occur about one to three hours after eating. Symptoms may include:

• Fatigue or weakness
• Flushing or sweating
• Shakiness, dizziness, fainting, or passing out
• Loss of concentration or mental confusion
• Feelings of hunger
• Rapid heartbeat

 

Dumping Syndrome: Causes of the Late Phase

The symptoms of this late phase may occur due to a rapid rise and fall in blood sugar levels. The cause of this rapid swing in blood sugar may be due to eating sweets or other simple carbohydrates.

 

If we do dump, it would raise a whole lot of new issues that we would need more information on.  For example, how does this relate to the hypoglycemia that is seen in RNY patients that are 5-10 years out, and what about all the other ailments that the RNY crowd have to look forward to in the future?  I know that the pyloric valve should reduce a number of these issues, but I am curious what the ramifications of dumping are for us in the long term. 

I know that we empty our stomach faster over time than normies, does this mean that this is progressive?  I now have more questions to research.  I hope Ruggie reads this and chimes in.

I don't know yet.  I haven't really eaten any significant carbs yet....probably the worst thing I have done is eat some crackers or the fruit I mix into my greek yogurt.

Oh wait....yes I did eat a single Hershey Miniature about a month ago.  I don't remember feeling any different afterwards.  Maybe that isn't enough to trigger anything?

I dump and it's horrible! I dumped eating too much on my birthday. For me I get really nauseous them dizzy and sweaty. After I need to lie down and basically sleep it off. I feel hungover after I wake up.

That's exactly what happens to me, too. 

Edited to correct iPad formatting problem...

 I would hardly think the study as being anywhere near conclusive.  In fact, the authors make very clear it's not a study, but a proposal for a study based on a single test of 31 patients.  Of those 45 percent showed some signs of dumping after surgery based on a single glucose stress test.  

Some significant issues I see are:    

1.  What was the timing of the test relative to the meal plans of the patients!  Because of the low caloric intakes of sleeve patients, especially during weight loss, it is possible to just have normal hypoglycemia if a meal is skipped.  Those symptoms are almost identical to early-stage dumping.  

2.  There was NO control group.  This could not be considered a scientific study without one.  This combined with the lack of a significant population, or any mention of this using either a blind o doubl-blind technique would cause serious methodology questions.  

3.  What was the dosage and methodology of the glucose delivery.  We're they given a single Tablet, or oral suspension?  How much fluid was given with the tablet?  You could force dumping style symptoms in any patient by varying those two numbers.  It's harder to force pre-op because of the large stomach - bigger tank to hold what you put in it.  Post op - push enough water that pelorus is gonna open up.   

I also question the source.  I don't see titles behind anyone's ame, and the author has a hotmail. Mail address instead of using an official university or hospital address.  

Sorry for the wonky formatting, OH isn't liking me typing on my iPad.

 I'm going to add my own personal experiences as well, I do not believe that I dump.  I have had bouts of hypoglycemia when I do not follow my schedule and eat at the right times.  That was especially true in my early days after surgery.

I do expect to have some issues in maintenance as I begin to reintroduce breads and starches.  Although my body will know ow to process them chemically, I will no longer b used to how that process makes me feel.

In the early 2000s after I was diagnosed with diabetes and lost about 80 lbs on a low carb diet I had a single Reese's peanut butter cup in a "what the hell" moment.  It was the sweetest thing I had ever tasted.  I was bouncing off the walls for an hour.  My friends reported that I was instantly "floting around".  It was a simple sugar rush, but it illustrates my point of just how extreme a reaction to reintroducing sugar can be after detoxing from it.

You are right, I saw all the same issues with this study.  However, what made me want to discuss this is that there is a growing number of studies and anecdotal evidence for an increased reaction to sugar/ carbs with the Sleeve.  I think your separation of real dumping and RH and just plain old hypoglycemia could very well answer some of these questions. 

My doctor does not believe that VSG patients dump, however, the faster gastric emptying has me questioning this.  I need to do more research which is why I posted this.  I knew that you guys would really come through, and you have done just that.  Thank you. 

 IN some of the articles that krzydoglady posted below, there is a lot of talk about the faster gastric emtying.  I have seen referneces to that in literature before.  

The engineer in me thinks of this in terms of a purely mechanical system - If I have a 10 gallon tank that empties when it fiils up based on a non timed mechanism, its naturally going to empty more frequently and faster if I reduce it to a 2 gallon tank.  

The mechanism for emptying in our bodies is biochemical, not mechanical but the analogy applies i think.  I think thats also why some people think of it as dumping when its really a different mechanism with similar symptoms.  Rather than sugar simply getting "dumped" into the intestines like a RNY patient, ours does get held in the stomach for a while.  The stomach just empties more rapidly than a normal stomach.

I would agree.  It seems pretty certain that our stomachs do empty quite a bit faster, possibly as much as 50% faster.  Does this lead to an increase in RH or simple hypoglycemia in the long run?  I am not sure that this has yet been answered.  It seems clear to me that the VSG can not be described as a purely restrictive procedure.  The main reason for the weight loss is restrictive, but there are numerous intended and unintended hormonal, mechanical, and other consequences.  I am a bit concerned that long term there will be more studies showing RH or SH in VSG patients. 

Don't get me wrong, I would do this surgery again in a heartbeat, but I do think we need to stay informed about long term consequences. 

 Agree completely.  Just like with the Rny community, there is a need for constant midfulness and maintenance.  We have altered our bodies and means a lifelong commitment to managing that.  

I'm not a firm believer in VSG resulting in TRUE dumping syndrome.  However, I do believe that this depends on your surgeon and what, if anything, they do to the pylorus as some surgeons do whatever they have to and, while someone may believe they ended up with a true VSG, they simply didn't.

I have seen dumping syndrome in a family member up close and personal.  This person had their full esophagus removed in addition to 75% of their stomach (pylorus included).  During a dumping episode...no kidding...they would PRAY for death.  Certainly not something that comes and goes, not something that you vomit and feel better or something anyone could ever sleep off. True dumping syndrome is as horrid as you could ever imagine.

That said, I also believe some VSGers are extremely carb and/or sugar sensitive and may experience reactive-hypoglycemia and, not knowing the difference, confuse the two.  Just my .02

wow, i have had this experience before without even having a sleeve.  when i tried an icecream sundae.  shakes, heartbeat, sweating, running to the bathroom.

all the more reason to not eat sugary crap.

This actually isn't a new finding. There's an older study  I have bookmarked at home that showed about 16% of VSG patients dump.  VSG is NOT a purely restrictive procedure.  Multiple studies have found that gastric emptying is about 50% faster than pre-op.  The sleeve creates pressure, and even with a pyloric valve food hits the intestines faster which is what triggers the 'Ileal Brake' and faster satiety. It follows that fast absorption of sugar would trigger simlar symptoms to 'dumping.'

I haven't eaten sugar except in very small quantities after protein, so I've not experienced dumping.