Dumping is a side-effect of Weight Loss (Bariatric) Surgery.
BENEFITS OF BARIATRIC SURGERY
Weight loss surgery can be a life-changing event. Weight loss operations are powerful tools to change diet and life-style. These operations empower obese people to lose large proportions of their body weight and to then sustain the loss. Also, there can be improvement or even cure of serious illnesses like diabetes, high blood pressure and high cholesterol. The risks for life-threatening problems like cancer and heart attack reduce significantly after weight loss surgery.
BALANCING BENEFITS AND SIDE-EFFECTS OF BARIATRIC SURGERY
But, weight loss surgery does have several side-effects. Like many other decisions, it is important to weigh the pros and cons carefully before going ahead with a weight loss operation. Once the problem is understood properly, it can be given the correct weightage in balancing it with the benefits. Also, proper understanding enables us to anticipate the problem and to deal with it. Often a side-effect can be avoided by taking proper preventative action.
DUMPING WITH GASTRIC BYPASS, SLEEVE GASTRECTOMY & GASTRIC BAND
In this post, we will discuss the side-effect called dumping. This side-effect can happen all the three common bariatric operations: gastric band, gastric bypass and sleeve gastrectomy. Although, dumping does seem to happen more frequently with the gastric bypass than with the sleeve gastrectomy, and it happens least with the band. Similarly, dumping tends to be more severe with the bypass than with the sleeve or the band.
HOW OFTEN DOES DUMPING HAPPEN AFTER BARIATRIC SURGERY?
There are many studies on dumping after bariatric surgery, and different figures have been reported. Severe hypoglycaemia is seen in about 1% of patients after gastric bypass surgery.
TYPES OF DUMPING
There are two types of dumping syndromes:
Early Dumping
After a weight loss operation, there can be rapid entry of food into the small bowel. This can stimulate the secretion of fluid from blood vessels into the bowel. Also, various hormones can get released from the wall of the bowel. These changes in fluids and hormones can produce abdominal pain, diarrhoea, loud bowel sounds, bloating and nausea. Also, there can be palpitations, sweating, flushing and faintness.
Late Dumping
There can be excessive release of insulin because of the rapid entry of carbohydrates into the small bowel. High levels of insulin cause a drop in the blood sugar levels and produce hypoglycaemia. Unlike early dumping, the symptoms do not occur immediately after eating. Instead, the symptoms show up about 1-3 hours after a meal. The common symptoms are hunger, weakness, confusion, tremors (shaking), faintness, palpitations and sweating.
WHAT IS THE TREATMENT OF DUMPING?
Proper advice about diet from a specialist bariatric dietician is very important. Small meals should be taken at regular intervals. About 6 small meals per day are advised usually. Water or other liquids should not be taken for at least 30 minutes after a meal. Simple carbohydrates (sweets), which are absorbed rapidly from the bowel, should be avoided. Instead, complex carbohydrates should be taken, and dietician can advise on a balanced diet. If hypoglycaemia cannot be controlled be controlled by diet modification only, then advice from a specialist in Endocrinology may be needed. The endocrinologist may advice treatment with drugs called Acarbose or Somastostatin. Rarely, continuous tube feeding or re-operation may be needed.
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