Hope Kicak thought she needed to clean up her diet: Eating was frequently leaving her bloated, crampy and even nauseous. “I started trying to focus on more healthy foods like veggies, salads and whole grains,”…
Hope Kicak thought she needed to clean up her diet: Eating was frequently leaving her bloated, crampy and even nauseous. “I started trying to focus on more healthy foods like veggies, salads and whole grains,” says Kicak, who was in her early 20s at the time.
In retrospect, she knows that was the worst thing she could have done. High-fiber foods only exacerbate dumping syndrome, a cluster of symptoms related to rapid gastric emptying. Kicak only learned the condition had a name a few years after her digestive tract went haywire.
“I was relieved to know I wasn’t crazy,” says Kicak, now a 28-year-old in upstate New York who also has gastroparesis, a contrasting condition in which the stomach doesn’t empty into the intestines as quickly as it should. “But I was also more frustrated (to receive the diagnoses), realizing the implications of having both too slow and too fast digestion occurring virtually all of the time with no rhyme or reason as to why.”
Years later, Kicak says, she still hasn’t entirely figured out what triggers either issue. “It makes it extremely difficult to plan what I can ‘safely’ eat, not knowing if something is going to sit for days or fly out of me at the speed of light,” she says.
“It’s very dramatic and can be very scary,” says Dr. Yamini Natarajan, an assistant professor in the department of gastroenterology at the Baylor College of Medicine and a spokesperson for the American Gastroenterological Association. “That sensation of pain, nausea, flushing, altered heart rate can feel almost as if they’re dying or very sick.”
While the episodes aren’t as medically dangerous as they can feel, if the condition doesn’t resolve or isn’t well-managed, over time, it can lead to malnourishment and dehydration. “Dumping makes it a lot harder to retain nutrients,” explains Kicak, who is on Social Security disability. “Because food is only in my system for a matter of minutes sometimes, my body doesn’t have a chance to absorb anything useful.”
Though not the case for Kicak, dumping syndrome is typically a side effect of weight loss and other surgeries including gastric bypass, gastric sleeve or surgeries for gastric cancer, peptic ulcer disease, pancreatic cancer or esophageal cancer. That’s because those procedures may damage, bypass or remove the pyloric valve, or the stretchy band of muscle at the bottom of the stomach that regulates how fast food and drink leave the stomach, explains Niki Strealy, a registered dietitian nutritionist in Portland, Oregon, who’s known as “the Diarrhea Dietitian.” Nerve damage related to poorly managed diabetes can also lead to dumping syndrome, Natarajan adds.
The condition — which one report estimates may occur in 20 to 50 percent of people who’ve undergone a gastric surgery, though in most of those cases it’s not severe — can be either “early” or “late,” Strealy explains. “Early dumping syndrome” happens about 30 to 60 minutes after a meal (when the body quickly pulls water into the intestine to balance out all the sugar it’s just received) and “late dumping syndrome” happens 2 to 3 hours after a meal (if the body overshoots insulin production to respond to the sugar spike in the small intestine).
Kicak has experience with early dumping syndrome. “You eat, and while still in the process of finishing your meal, your face flushes, your pulse speeds up, you can feel your heart pounding in your chest and in your ears, you feel your stomach twist in that familiar, horribly painful knot,” she explains. “You feel the sharp, piercing gas cramps hitting lower and lower until within moments you know — bathroom, now. You race to the toilet in a panic … and if you’re lucky, you make it in time to relieve yourself. It’s like food poisoning on fast forward.”
Preventing and Treating Dumping Syndrome
While it’s not always preventable, dumping syndrome is one reason it’s critical to go into weight-loss surgery with open eyes. “It’s important for patients to know that it’s an effective treatment for weight loss, but there are various side effects or complications that can happen,” Natarajan says.
It’s also worth noting that the symptoms can arise (and resolve) at different times. “There are different phases of recovery after stomach surgery,” Strealy says. “Some people have dumping syndrome immediately after surgery, while for others it can be months later. Learning the new way your body digests foods takes time.” Many people with early dumping syndrome get better after a few months, the Mayo Clinic reports.
But you don’t have to — and shouldn’t — just hope for the symptoms to clear up. Diet changes are often all that is needed to keep dumping at bay. A registered dietitian can help ensure you get the best nutrition with the fewest side effects. Strealy recommends six small meals a day, limiting fluids at mealtimes, eating protein and small amounts of fat with each meal, cutting out sugary foods and drinks, avoiding super hot or cold food and drinks, and steering clear of caffeine. “Dietary changes really can cause a vast improvement in symptoms in most patients,” Natarajan says. If they don’t, certain medications and — in rare cases — additional surgeries can help.
For Kicak, whose dumping syndrome is likely chronic malfunction of her digestive tract, disease management means being prepared: She always travels with wet wipes, makes sure she knows where the nearest bathroom is and sometimes wears adult diapers “just in case.” “If you think you have a digestive disorder, go see a gastroenterologist,” she advises, adding that you may need to see several specialists like she did since the symptoms can be misdiagnosed or brushed off as related to stress, poor diet or menstruation. “Don’t give up,” Kicak says. “You are not alone and you’re not crazy.”