Colorado Center for Digestive Disorders

"Dumping syndrome" describes a variety of symptoms that some people have when they eat a meal after having stomach surgery. These symptoms include stomach cramps, nausea, vomiting, sweating, weakness, and diarrhea. People usually have these problems 10-30 minutes after having a meal.

"Dumping syndrome" happens when food passes too quickly from the stomach into the intestines. Eating concentrated sugars often causes this. When excess sugar is present in the intestines, the body responds by pulling fluid from the tissues into the intestines. Excess fluid in the gut causes cramping and diarrhea. The fluid shift can also make blood pressure drop, causing weakness and sweating.

Symptoms of "dumping syndrome" have also been seen in some people 1-4 hours after eating a post surgery meal. This is called "late dumping syndrome." Late dumping syndrome also happens because of consuming concentrated sugars. However, in this case, sugar is quickly absorbed into the bloodstream causing a high blood sugar level. A high blood sugar level signals the body to make more insulin. Excess insulin causes low blood sugar (hypoglycemia), weakness, sweating, and a rapid heart rate.

Making diet changes can be useful in preventing dumping syndrome. The following guidelines are recommended to prevent foods from being emptied from the stomach into the intestines too quickly following stomach surgery:

Limit concentrated sugars like cookies, cake, pies, sugar, and syrup.
Eat six small meals daily instead of three large meals.
Eat Slowly.
Drink low sugar beverages slowly between meals. Wait at least one half hour after eating a meal to drink fluids.
Avoid drinking beverages that are too hot or too cold. Beverages at extreme temperatures might worsen symptoms.
Eat adequate amounts of protein and fat.
Lie down for 15 to 20 minutes after a meal to slow the movement of food from the stomach to the intestines.

The following table will help you to choose foods best tolerated after gastric surgery:

	Better Tolerated	Less Tolerated
Grains	Plain breads, buns, bagels, and crackers; unsweetened cereals; pasta; rice; pretzels	Sweetened cereals; donuts and sweet rolls.
Fruits	Fresh fruit, fruit canned in natural juice, unsweetened fruit juice.	Frozen or dried fruit; fruit cooked or canned with sugar; sweetened fruit juice, prune juice.
Vegetables	All	None
Meats/meatless protein	All meat, poultry, and fish; peanut butter.	None.
Dairy	Whole, 2%, 1% or skim milk; buttermilk; cheese; sugar-free pudding; yogurt sweetened with sugar substitute.	Malted or chocolate milk; sweetened custard, pudding, or yogurt.
Fats/Oils	Butter, cream, margarine, oils, fats, mayonnaise, salad dressings.	None.
Sweets	Sugar-free gelatin or custard; sugar free ice cream; sugar substitute.	Cakes, cookies, pies, pastries; puddings, sherbert, ice cream, milkshakes; gelatin; candy; sugar, jams, jellies, honey, syrup.
Beverages	Water, tea, coffee, diet soda, sugar free beverages.	Regular soda, sweetened drink mixes and tea, Koolaid, fruit drinks, and punch.

Sample Menu

Post Gastrectomy/Dumping syndrome Diet

Breakfast	Lunch	Dinner
½ cup unsweetened orange juice 1 plain bagel 1 tbsp plain cream cheese	1 pita pocket 3 oz lean roast beef sliced tomato, lettuce, and sprouts 1 tbsp mayonnaise 6 oz diet soda	1 medium baked potato 3 oz broiled haddock 1/2 cup cooked spinach 1 tsp margarine 1 tbsp sour cream ½ cup coffee 1 tsp non-dairy creamer sugar substitute
Mid-morning snack	Mid-afternoon snack	Evening Snack
1 cup unsweetened cereal 1 cup 2% milk 1 medium apple	8 oz sugar free yogurt ½ cup peaches packed in natural juices 1 oz pretzels	2 slices bread 1 oz turkey breast lettuce wedge mustard ½ cup 2% milk

This Sample Menu Provides:

Calories 1800 Fat 47 grams

Protein 87 grams Sodium 2477 mg

Carbohydrate 260 grams Potassium 3384 mg