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Nausea with Dumping Syndrome After WLS? Here’s How to Fight it!

Dealing-With-Nausea-Post-Weight-Loss-Surgery


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Weight loss surgery reduces the holding capacity of the stomach, due to which foods high in refined sugar or dairy products can get dumped rapidly into the small intestine. This phenomenon is referred to as ‘Dumping Syndrome’, and can often lead to nausea and vomiting.

Watch your eating habits if you encounter nausea along with any of the following symptoms:

  • Sweating
  • Cramps in the stomach
  • Bloating
  • Fatigue and weakness
  • Dizziness
  • Rapid heart rate

Causes of Nausea After Dumping Syndrome

Early and Late Causes of Nausea of Bariatric Surgery

  1. Early Dumping Syndrome

  • Normally, it takes a few hours for the food to advance from the stomach to the intestine.
  • After weight loss surgery, a part of the stomach is either bypassed or its size is reduced.
  • As a result of this, the food reaches the intestine at a faster pace.
  • Consequently, the intestine expands especially due to the presence of sweet foods, and additional fluids are released to handle them.
  • This can lead to nausea and bloating within 30 minutes of eating.
  • According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)1, 75% of people suffering from dumping syndrome experience early symptoms.
  1. Late Dumping Syndrome

  • Foods rich in sugar can also raise the glucose level of the blood.
  • Initially, the pancreas release insulin to combat this sudden increase in the blood glucose level.
  • As a result, the glucose level drops down abnormally, leading to hypoglycemia, which causes nausea approximately 3 hours after a meal is taken.

How is Dumping Syndrome Diagnosed?

Diagnosing Dumping Syndrome after Bariatric Surgery

Doctors may conduct any or all of the following tests to check if nausea and other symptoms are associated with dumping syndrome.

  1. Glucose test – Since hypoglycemia is one of the major symptoms of late dumping syndrome, a test that checks blood sugar levels helps in the detection of the problem. For this:
  • The doctor measures the glucose concentration in the blood and a set of other dimensions before administering a glucose solution.
  • After drinking the solution, the measurements of the individual are checked again after regular intervals of up to 180 minutes.
  • If the patient shows low blood sugar levels between intervals of 120 minutes and 180 minutes, he/she might be suffering from dumping syndrome.
  1. Medical assessment – The doctor may also take into consideration your medical history as well as various other symptoms that occur along with nausea after bariatric surgery.
  2. Scintigraphy – This test involves placing a radioactive material in a bland meal, which when consumed, helps in detecting the rate of gastric emptying through medical imaging.
  3. Endoscopy and X-rays – An endoscope mounted with a camera is placed inside the gastrointestinal tract to study anatomy closely. Similarly, X-rays are performed in combination with barium for more prominent images of the tract.

Note that some of these tests may make you feel nauseated for some time. Therefore, do not confuse the mild symptoms with those of dumping syndrome.

Eating Habits to Adopt After Bariatric Surgery

General Diet Guidelines Post WLS

  • In no case should you have candies, honey, sweets, baked goods, or sodas. (in other words, anything that may contain large amounts of sugar)
  • Move from the conventional diet of three large meals to a newer one comprising of approximately five smaller meals in a day.
  • Incorporate more protein, complex carbohydrates such as oatmeal, and fiber-rich foods. The portions, however, should be kept fairly small (15 gms or less, initially).
  • Substitute table sugar with supplements wherever possible.
  • Do not eat beyond the point of fullness. Never force anything down your delicate stomach after surgery.
  • Drink plenty of fluids but don’t forget to follow the 30-minute drinking rule post-bariatric surgery.
  • Ask a bariatric nutritionist to help you with a diet plan for improved results.

How to Overcome Nausea and Dumping Syndrome?

  1. Medication – When dietary measures prove futile, your doctor may recommend certain medication that hampers the process of gastric emptying. As per the NIDDK1, octreotide may be administered into the skin for this purpose, with the help of an injection after every four weeks.
  2. Other Alternatives – According to Mayo Clinic2, adding certain ingredients to food such as pectin or guar gum can condense its texture and slow down its movement in the gastrointestinal tract.
  3. Surgical interventions – Occasionally, surgery may be performed either to revise the previous bariatric surgery causing dumping syndrome or simply to end post-operative nausea and vomiting (PONV) symptoms when all other efforts have been unavailing. It is generally not recommended, as according to the NIDDK1, it is often unsuccessful.

Nausea after weight loss surgery due to dumping syndrome occurs when the small intestine is deluged with food and fluids beyond its handling capacity. The symptoms of early dumping syndrome slowly fade away on their own after a few months, if mindful eating is practiced. Ask your doctor about other possible courses of action in case they don’t. 

References:

  1. “Dumping Syndrome.” National Institute of Diabetes and Digestive and Kidney Diseases, 2013, https://www.niddk.nih.gov/health-information /digestive-diseases/dumping-syndrome/
  2. Mayo Clinic Staff. “Dumping syndrome – Diagnosis & Treatment.” Mayo Clinic, 2018, https://www.mayoclinic.org/diseases-conditions/dumping-syndrome/diagnosis-treatment/drc-20371922

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