Dumping Syndrome: How Early/ Late Dumping Occurs After Bariatrics
Stomach stretching, abdominal cramps,
Risks & Benefits | Gastric Bypass
Surgery | Biliopancreatic
Diversion | Roux-en-Y
Dumping Syndrome: How it Happens
Early Dumping: Causes & Symptoms
Early dumping (rapid gastric emptying) typically starts during or immediately after a meal. It is typically triggered by the high osmolarity (molecular density) of simple carbohydrates in the intestine. Most sugars have small molecules, so that a gram of (say) table sugar has a much larger number of molecules than (say) a gram of protein. This high concentration or density of molecules attracts a correspondingly large amount of fluid to the small bowel causes it to become stretched (causing cramping pain). In turn, these cramps trigger hormonal and nerve responses that cause the heart to race (causing palpitations) and also cause the patient to become clammy and sweaty. Finally, as the small intestine tries to expel the problem, the patient may experience vomiting or diarrhea.
Late Dumping: Causes & Symptoms
Late dumping (rapid gastric emptying) typically occurs 1-3 hours after eating. Late dumping is caused by fluctations in blood glucose levels among patients whose digestive anatomy has been altered by bariatric surgery, like gastric bypass. When sugar is eaten it is rapidly absorbed into the bloodstream triggering a rapid rise in blood sugar levels. The pancreas responds by secreting an equally large amount of insulin to soak up the excess blood sugar. However, because the amount of sugar that instigated all this was so small, there is now too much insulin in the blood, and this triggers the common hypoglycemic symptoms of late dumping, such as: weakness, dizziness and fatigue.
Effect of Gastric Surgery on Dumping
Gastric bypass alters the anatomy of the digestive tract by reducing the stomach and bypassing the duodenum. This can lead to the arrival of an unusually large amount of undigested food in the jejunum, which causes early dumping. In normal people, the food passes out of the stomach at a more controlled rate and is partially digested in the duodenum. These digestive alterations also cause late dumping, since in normal people the stomach, pancreas, and liver combine to "prepare" sugar before it reaches the small intestine. Also, the sugar is accompanied by stomach acid, bile, and pancreatic digestive juices which inhibits the side effects mentioned above.
BARIATRIC SURGERY INFORMATION