DUMPING

SYNDROME
By: Adler Valdez, Erica Tamondong, Justine Sumang,
Reyn Zoleta
Scenario
Following surgery to address PUD, the individual shows
excessive sweating, rapid heart rate, and low blood
pressure an hour after eating. Furthermore, the patient
reports abdominal cramps, fatigue, and emesis.
Pre-Assessment: Critical Thinking
What options can be included in the patient's care strategy to relieve
their signs and symptoms? Choose all that are applicable.

a. Allow a 30-minute gap between meals and liquid intake.

b. Maintain an upright position for 30 minutes following meals.
c. Incorporate generous daily servings of dairy into your diet.
d. Opt for 5 to 6 smaller meals throughout the day, as opposed to three
larger ones.
e. When experiencing symptoms, consider consuming cold foods to
alleviate them.
f. Give Thiothixene to delay gastric emptying.
Dumping Syndrome
• When your stomach moves food into your
small intestine faster than it should.

• “Rapid gastric emptying”

• Associated with gastric bypass surgery

Causes of Dumping Syndrome

Impaired Gastric Post-surgery & Diet

Motility Underlying Disease
It throws off your ability to 20%-50% of people who Refined sugars in your
digest have had surgery on their stomach can absorb water
stomach will get some fast
symptoms of dumping
syndrome
Two Phases of Dumping Syndrome
Early Dumping
● Food is rapidly "dumping" into the small
intestine.
● Usually happen about 10-30 minutes
after you finish eating.
● Small intestine stretches because it pulls
water in from your blood to help digest.
Late Dumping
● Usually happen about 1-3 hours
after a meal, especially if you ate
a lot of carbohydrates.
● Due to a fast rise and fall in blood
sugar levels.

● Small intestine releases hormones into

your bloodstream, which may cause
changes in your blood pressure and
heart rate.
Signs and Symptoms of D.S
Early Dumping Late Dumping
● A feeling of fullness or bloating, even ● Weakness or fatigues
after eating just a small amount
● Jitters or shakiness
● Belly cramping or pain
● Rapid or irregular heartbeat
● Nausea or vomiting
● Cold sweats/ Diaphoresis
● Diarrhea
● Face flushing
● Flushing or light-headedness
● Brain fog
● Tachycardia
● Feelings of hunger
Diagnosis and Tests
This measures your blood sugar before and after you drink a
Oral Glucose Tolerance Test glucose solution. If your blood sugar drops 1-3 hours after you
eat, this likely means you have late-phase

Your doctor can look at the inside of your stomach, esophagus,

Upper Endoscopy and the connection between them to see if you have any
structural problems

The technician will watch on the fluoroscope as the contrast

Upper Gastrointestinal Series solution travels through your stomach and into your small
intestine.

This measures hydrogen levels in your breath after you drink a

Hydrogen Breath Test glucose solution. If you have hydrogen in your breath, it shows
that glucose isn't being absorbed in your small intestine well

Gastric Emptying Test This measures how quickly food moves through your stomach
Management and Treatment
Eat smaller meals more frequently
• Six to eight small meals
• Eat slowly and chew thoroughly

Avoid simple sugars, carbohydrates

and milk products
• Prevents rapid blood sugar shifts

Eat more protein and healthy fats

• Replace carbohydrates in your diet
Management and Treatment
Eat more dietary fiber
• Fiber slows down sugar absorption in
your digestive system

Lie down on your back for 30 minutes

after eating
• This may slow down gastric emptying
• Help maintain blood pressure during digestion.

Don’t drink fluids within 30 minutes

before or after eating
• Fluids encourage motility.
Recommended Foods
What foods should I eat while living with Dumping Syndrome?

Eggs, meat, poultry, fish, nuts and nut butters,

Protein
beans and legumes
Butter, mayonnaise, salad dressings, avocados,
Fats
oily fish, nuts and nut butters.
Unsweetened whole grain cereal, oatmeal, bread,
Complex Carbohydrates
rice and pasta.
Peas, beans, apples, oranges, carrots, broccoli and
Soluble fiber brussels sprouts.
Foods to Avoid!
What foods should not eat while living with Dumping Syndrome?

Cookies, candy, packaged breakfast cereals,

Sweets
sugary drinks and desserts
Milk, cream, yogurt and cheese (if they bother
Dairy
you).
Unsweetened whole grain cereal, oatmeal, bread,
Complex Carbohydrates
rice and pasta
Nutritional shakes and liquid nutritional
Calorie-rich drinks supplements.
Drug of Choice
When you change your diet, there are some medicines that your doctor can prescribe.

Octreotide acetate Acarbose

Precose
Sandostatin

• slows down gastric emptying and • Slows down your digestion of

small intestinal transit time carbohydrates

• suppresses insulin • Keep your blood sugar in balance

• given as an injection, either daily • Reduce some symptoms from late-

(short-acting form) or monthly (long- phase dumping syndrome
acting form).
Is Dumping Syndrome Serious?
Under normal circumstances, dumping
syndrome is not dangerous or life-
threatening. A severe case can cause
rapid weight loss and nutritional
deficiencies. Persistent, unmanaged
diarrhea can cause dehydration, but
these complications can usually be
managed or prevented with self-care.
Most people have mild symptoms that
ease over time. Dumping syndrome is
not usually permanent and it is self
limiting
Clues
Following surgery to address PUD, the individual shows
excessive sweating, rapid heart rate, and low blood
pressure an hour after eating. Furthermore, the patient
reports abdominal cramps, fatigue, and emesis.
Answer & Rationale
What options can be included in the patient's care strategy to relieve
their signs and symptoms? Choose all that are applicable.

a. Allow a 30-minute gap between meals and liquid intake.

b. Maintain an upright position for 30 minutes following meals.
c. Incorporate generous daily servings of dairy into your diet.
d. Opt for 5 to 6 smaller meals throughout the day, as opposed to three
larger ones.
e. When experiencing symptoms, consider consuming cold foods to
alleviate them.
f. Give Thiothixene to delay gastric emptying.
Let’s Recap!
Dumping Syndrome Management:

Basic Principle of Dumping Syndrome: ______

_____ FIBER (as tolerated)

_____ PROTEIN
_____ CARBOHYDRATES (simple)

MEALS: ___
FLUIDS: ___

POSITION: _____

MEDICATIONS: _______
Screenshot mo ‘to bes!
Dumping Syndrome Management:

Basic Principle of Dumping Syndrome: Delay gastric emptying

HIGH FIBER (as tolerated)

HIGH PROTEIN
LOW CARBOHYDRATES (simple)

MEALS: SFF
FLUIDS: In between meals

POSITION: Lie down after meals; Left

MEDICATIONS: Anticholinegic / Antipasmodic

THANK YOU
FOR
LISTENING