Dumping Syndrome: Priorities for Managing Market Challenges and Risks

April 2021

Dumping syndrome is a condition that usually develops after surgery in which stomach contents are prematurely released into the small intestine. It can have a wide variety of symptoms, from nausea and vomiting to diarrhea, often followed by a compensatory feeling of fullness. In some people dumping syndrome causes weight loss because food is not absorbed properly and passes out in the stool. 

The most common cause of dumping syndrome is gastric bypass surgery for weight loss. Dumping syndrome also develops after surgery for ulcers or gallstones, certain types of pancreatitis, Crohn's disease or IBS (inflammatory bowel disease). 

The symptoms of dumping syndrome are usually relieved by eating, and the condition has a tendency to resolve with time. Treatment is aimed at triggering an earlier emptying of the stomach or at decreasing the dumping effect. 

Dumping syndrome after gastric bypass surgery was first reported by Francis Gano Benedict (1852-1927), a surgeon at New York Hospital, in 1893. He illustrated this condition with two case histories: one in a 45-year-old woman who had undergone an upper gastric resection for cancer and another in a 37-year-old woman who had undergone lower gastric resection for intractable heartburn.  

Diagnosis: Diagnosis of dumping syndrome is usually clinical. Stool can be tested for sugar content, and a gastric emptying scan can help to distinguish between dumping syndrome and gastroparesis. A study of people who had undergone gastric bypass surgery found a high prevalence of symptoms consistent with the dumping syndrome. 

The dumping syndrome is caused by gastric stasis. Normally, the upper small intestine (the duodenum) empties at around the same time as the stomach. However, if food is not completely digested in the stomach, it travels slowly into the small intestine. This causes fluid containing sugar (which often contains nutrients that were not absorbed from the food) to enter the small intestine before all of the nutrients have been absorbed in the stomach. 

Dumping Syndrome is a stomach condition that occurs when a person eats foods high in carbohydrates. When these foods are absorbed into the bloodstream, they are directed to the small intestine where enzymes break them down into simple sugars like glucose and fructose. The pancreas produces insulin to lower blood sugar levels by converting the sugars into energy or fat and storing them away. 

Sometimes, the entire process gets reversed when food leaves the small intestine before it can be digested and sent back to your stomach for storage as fat. This process of dumping food from your stomach back into your intestines is called dumping syndrome because it feels like you're dumping something out of your bowel or rectum often causing nausea, abdominal cramping, diarrhea, gas, and bloating. 

According to studies, about 20% of the population experiences dumping and 80% of all diabetics have it at one time or another. That said, dumping is not a common symptom for diabetics and in fact, that group actually has better blood glucose control than non-diabetics with dumping. In other words, most diabetics don't experience dumping at all so it's not a common diagnosis among the disease population. People who are obese and have damaged small intestine muscles tend to experience dumping though some people who are thin with normal muscle strength can get it as well. Among the overweight population, body fat percentage definitely increases risk because belly fat acts like a compressed sponge that collects food too long before being dumped.

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