What is/causes Dumping?

hollykim
on 8/3/14 8:52 am - Nashville, TN
Revision on 03/18/15
On August 3, 2014 at 9:08 AM Pacific Time, Just Ducky wrote:

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

 

don't you mean"...people WITH a pyloric like those with sleeves and bands..."?

 


          

 

MyLady Heidi
on 8/3/14 12:26 pm

That part of that sentence was after, only people with rny dump=those without pyloric valves, those with pyloric valves, i.e. sleeves, bands don't dump sugar directly into their bloodstream, same for alcohol.  But my issue is more the math 30% dump which means 70% don't dump not 80%.  

Just Ducky - The
Meditative Hag

on 8/4/14 3:57 am - Belleville, IL

As Ms. Batt and a few others pointed out ANYONE can potentially dump after abdominal surgery, however RNYers tend to dump the most. Even then only 30% of RNY folks dump. I will only say with ANY surgery (Band/Sleeve/VSG/RNY/DS) you have to figure out your OWN sugar load. Mine may be "I'm fine with anything 19 grams or under" (and check what your SERVING size is!) Suzie's sugar tolerance may only by 6 grams of sugar or under.   I apologize if I come off as "snarky" and not trying to insult anyone.  After any kind of surgery to our stomach our Vagus nerve is often changed OR "more sensitive".  I have days where I too get a weird feeling, a slightly higher heart rate after eating (around 80-90) and my nose runs like a leaky faucet. But that is my new way of my body telling me I'm full.  (Your mileage may vary)

You can only really DUMP on sugar or simple carbs. Since meat has no sugar, you can't dump on it. Some people are lactose intolerant after surgery and for some people natural fruits CAN cause dumping. Anything with an "ose" in it is sugar..Fructose, Lactose, Dextrose, Sucrose, High Fructose Corn Syrup, Corn Syrup, Honey, Agave...All the above have potential to cause it.  I wrote the post mainly because many newbies were saying chicken or plain salad or eggs were causing "dumping" when in fact what they were describing was more of grumpy pouch, intolerance or "stuck food"... 4 years out chicken STILL makes my pouch and me feel like crap....It can be hard to digest for me.

Alcohol...Yes, a big no-no...Not only is it empty calories and can contain a lot of sugar but worse in RNY people it drops directly into your small intestine and hits you nearly instantly. You can get drunker faster, but even worse, even one glass of wine will make your blood alcohol limit go above the legal limit.  For me, Alcohol doesn't even MAKE me drunk or sleepy or high, but I know that it is in my blood and if I were to drive I'd be over the legal limit....This was so stressed by my surgeons office we had to sign a waver stating that if we had an RNY we realized what could happen if we drank.

Because this is the RNY board my messages are obviously directed mostly to the RNY community. Those with VSG/Bands or a pylorus intact will have different problems and different outcomes. However I've known Ms Batt for many years and respect her knowledge and she was right in pointing out that technically ANY stomach/intestinal surgery can cause dumping.

I wish everyone only the best of luck, no fighting, just offering information.

Warmly,

Ducky

   
    
hollykim
on 8/4/14 7:09 am - Nashville, TN
Revision on 03/18/15

I was trying to point out a grMmatical error that mightbe confusing to others *****ad the post...

 


          

 

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