Post-Gastrectomy Diet (anti-dumping)

What are the symptoms of the dumping syndrome?

The dumping syndrome occurs in some patients who have undergone stomach surgery. The symptoms include bloating, nausea, diarrhea, dizziness, weakness, sweating and rapid heartbeat. They may occur 30 to 60 minutes after eating a meal and then again, 2 to 3 hours after eating. The early symptoms are caused when concentrated sugar passes too rapidly from the stomach into the intestine.

What is the scientific explanation of the dumping syndrome?

The body dilutes this sugar mixture by bringing fluid from the body tissues into the intestine, giving a sense of fullness, cramping and occasionally diarrhea. The loss of water from tissues can produce a temporary drop in blood pressure, with resulting weakness and faintness. The latter symptoms are caused by the rapid absorption of sugar into the blood stream, which raises the amount of blood sugar. A high level of blood sugar signals the body to produce more insulin. The excess insulin, in turn, drives blood sugar levels down. The low blood sugar (hypoglycemia) produces the weakness, hunger and rapid heart rate that may occur about 2 to 3 hours after eating.

What is an anti-dumping diet?

This diet is really a regular diet with frequent small meals and reduced simple sugars. Depending upon individual tolerance and food selection, the Anti-Dumping or Post Gastrectomy Diet is adequate in all nutrients according to the National Research Council’s Recommended Dietary Allowances (RDA). Depending on the type and extent of gastric surgery performed, poor absorption of nutrients, vitamins and minerals may occur to a significant degree. Some patients may become deficient in iron, calcium, folate and B-12. The physician may prescribe vitamin/mineral supplementation and B-12 injections.

What are the general recommendations of this diet?

1. Eat six small meals daily to avoid overloading the stomach.
2. Limit fluids to 4oz (1/2 cup) during mealtimes. This prevents the rapid movement of food through the upper gastrointestinal tract and allows adequate absorption of nutrients.
3. Drink liquids 30 to 40 minutes before eating and 1 hour after eating, rather than with meals.
4. Rest or lie down for 15 minutes after a meal to decrease movement of food from the stomach to the small intestine. This decreases the severity of symptoms.
5. Avoid sweets and sugars. They aggravate the dumping syndrome.
6. Avoid very hot and cold foods or liquids, which may increase symptoms in some patients.
7. Stomach surgery is performed for different reasons, so calorie requirements may vary from patient to patient who has had surgery for severe obesity will need to be on a weight reduction program, A very thin patient who has had ulcer or cancer surgery will need extra calories.