What is/causes Dumping?

There are so many "newbies" here with dumping questions or claiming they are dumping and aren't so let's set out what DUMPING is and is NOT.

First, really only RNY folks dump. People without a pyloric valve, which means Sleeve and Band folks do NOT dump. Of RNY patients, only around 30% dump, a very LOW amount, which means 80% do NOT dump, even after eating high sugar etc... Now. What is TRUE dumping syndrome?

"Early Dumping"

Symptoms of dumping syndrome are most common during a meal or within 15 to 30 minutes following a meal. They include:

Gastrointestinal

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Feeling of fullness

Cardiovascular

• Flushing
• Dizziness, lightheadedness
• Heart palpitations, rapid heart rate
• (Courtesy of the Mayo Clinic)

How you will feel........... "Like you are going to die. Shaky, like you will pass out, heart pounding, miserable. Like horrific sea sickness"

Late Dumping or Reactive Hypoglycemia:

Signs and symptoms also can develop later, usually one to three hours after eating. This is due to the dumping of large amount of sugars into the small intestine (hyperglycemia). In response, the body releases large amounts of insulin to absorb the sugars, leading to low levels of sugar in the body (hypoglycemia). Symptoms of late dumping can include:

• Sweating
• Hunger
• Fatigue
• Dizziness, lightheadedness
• Confusion
• Heart palpitations, rapid heart rate
• Fainting
• Courtesy of the Mayo Clinic....    This is a much more SERIOUS form and is not so much "Dumping" as Reactive Hypoglycemia. It can on occasion be life threatening if your blood sugar drops to low. 
   "How it feels".... Like you are going to pass out, you may have shaking or seizures, confusion not being able to talk. A sense of impending doom, numbness, not being able to walk or function. You will NOT have nausea or vomiting or "pain".

Things that people MISTAKE for "Dumping".....

1) FOAMIES: This is when you either eat TOO much, too fast or have a large piece of food stuck in your stoma...  "What it feels like".  Lots of nausea and lots of liquid/slime/mucus comes up into your mouth. You may or may not vomit but feel yucky in your tummy.   (What to do). Try sipping WARM water or tea or chewing 1-2 Bromaine or papaya digestive capsules. This happens a lot after eating dense meat or fatty meat to fast.

2) Overloaded Pouch:  Your sense of fullness is different now than before surgery. Remember it takes 20 minutes for your pouch/stomach to tell your MIND that you are full.  "What it feels like" painful/crampy (especially if from a fatty meal) nausea, may or may not vomit, tiredness, a sense of "not feeling well". Possible needing to have a bowel movement.  Throwing to much "fatty" food into your pouch can make your liver/gallbladder/pancreas work overtime. It dumps a lot of bile trying to clean up the fat from your meal because you no longer have a pyloric valve or proper stomach acid to "digest" your meal.  What to do... Use your papaya chew to help break down the fat. Sip (NOT gulp but SIP very slowly) some warm tea, coffee or warm non-sugar, non-fat liquid. Try to walk around, maybe take a warm shower do light exercise to help the food go through your system.

3) Cranky Pouch:  Some days, whether we are newly out or 10 years out our pouch/stomach can be cranky as a baby. What might have sat well and tasted yummy yesterday or last week, now suddenly makes you feel awful and like crap (Same symptoms as Overloaded Pouch) Sometimes this just happens. No one knows why....The pouch just is grumpy some days, or it may be a slight flu or slight food poisoning.  What to do...Only time can help. Rest, lay down, take a shower, sip WARM liquid and see if it helps.

As you can see....NOT everything is "Dumping" in fact unless you are eating full sugar items you probably aren't dumping. If you are one of the rare 30% of Dumpers and you just chowed down a whole Hershey Bar, well, you get what you expect. Consider it something to help keep you on track.  You will NOT dump on veggies, meat or complex carbs unless they are prepared with a lot of sugar (usually 10grams or more) or very high fat content (oil, butter, lard, etc)

Sometimes Gallbladder attacks can feel like "dumping" too if you are uninitiated. What IS more serious to many RNY'ers is Reactive Hypoglycemia. (sometimes mistakenly called Late dumping). I didn't develop it until 2 years out, some never develop it, but it's best to know what it is. You treat it like diabetic low blood sugar and it can be very, very, serious (Causing seizures, black outs, passing out, etc). If you experience Reactive Hypoglycemia get a glucose meter and carry a roll of lifesavers (NOT sugar free) or full sugar Jolly Ranchers. Test your blood sugar and once it is slowly rising up, get some COMPLEX carbs and protein in you (Cheese cubes on wasa crackers or something like that.)

I am NOT a doctor nor do I pretend that I know everything. Your surgeons should be helpful to you, but so many throw around "Dumping" in a casual way and yet they are NOT experiencing dumping at all. If you dump (or have reactive hypoglycemia) you definitely know it. If you are throwing up foam and mucus and feel nausea you just have grumpy pouch, foamies or ate too fast.

Warmly,

Ducky

Five years out-sleeve people have a type of dump caused by a nerve behind new stomach-mine is nose running-some have coughing-sneezing-hiccuping-I call it a dumping whether it is technically or not-also docs seldom talk about it

That sounds more like your vagal nerve telling you that your full....Many of us who are sleeved/RNY/DS have new ways of our "stomachs" telling us we are "full" mine is hiccups and a nose that runs like a faucet...It is not dumping though, and confusing people by saying it's dumping causes problems. JMHO....

Warmly,

Ducky

Thanks for a great post.  I remember hearing about early and late stage dumping when I was a very new post-op.  I did not dump until many years later but never could remember what early and late stage meant. 

Actually anyone CAN dump, even those who've never had WLS---it's just far more common when the pylorus is bypassed. Having any sort of surgery on the stoma*****reases your odds of dumping.

But it's true that many, many people think they're dumping when they're not.

Thanks Ms. Batt, very true! Any stomach surgery can cause it, but yes, losing the pylorus valve "increases" it more than those whose pyloric valves are intact.  As always your advice is spot on and welcomed.  Wondering if DS people dump much? (I'd assume far less than the RNY 30%)

Warmly,

Ducky

I can't speak about the DS, but I had Mini-Gastric Bypass  (4-6 oz. sleeve, 6 ft. intestinal bypass with a single anastomosis, pyloric valve attached to remnant stomach) and I have experienced early dumping. My intestines look and act more like a RNYer's, so it makes sense that I'd be prone. I get the foamies, too. The way I tell the difference is if I have muscle weakness and rapid heartbeat, I know it's dumping. I'm past the learning curve, thank goodness, so I don't get either very often.

Was this passive aggressively directed at me? lol Regardless, I still stand by my statement. 

Thanks for the info.

As someone only 4 1/2 weeks out I just wanted to say THANK YOU! I've been reading everything about dumping and trying to read all labels and whatnot. A few days after surgery my dad accidentally gave me non-diluted cranberry juice, and even though I only took a very tiny sip before I realized it wasn't diluted 20 minutes later my head was spinning and I was so lightheaded I couldn't get up. Now I'm so nervous that I'm going to dump on small amounts of sugars, but I'm not sure if it was because I was only a few days post op. But anyway thank you for taking the time to write this post!

So I'm a VSG and there have been a few times that I've gotten very flushed and sweaty post eating.  When I've checked my pulse it's been up in the 80s instead of in the 50s where it normally stays.  

What is this?