Rapid Gastric Emptying

Rapid gastric emptying, otherwise known as dumping syndrome, is a condition that occurs after stomach surgery. Rapid gastric emptying occurs if the lower portion of the small intestine, known as the jejunum, fills with food that has passed through the stomach without being fully digested.

Rapid gastric emptying is usually described as early and late dumping, with early dumping occurring very shortly after a meal, while late dumping usually occurs around 3 hours since eating. It is possible to suffer from early and late dumping syndrome.

Rapid gastric emptying can be worrying at first, but it is not a serious or life-threatening condition and it can usually be managed very effectively by making small changes to your diet and eating habits.

What are the causes?

The chief cause of rapid gastric emptying is stomach surgery. Following gastric surgery it can be difficult to control the movement of food through the digestive system, resulting in food which has not been fully digested being ‘dumped’ into the small intestine. Eating foods high in sugar and fat and dairy products can increase the risk of dumping syndrome.

Early symptoms of dumping syndrome are caused by undigested food being pushed into the small intestine, while symptoms of late dumping syndrome may be caused by a rise and rapid fall in blood sugar.

A rare condition called Zollinger-Ellison syndrome can also increase the risk of an individual developing dumping syndrome.

Symptoms of rapid gastric emptying

Symptoms of rapid gastric emptying usually differ according to whether an individual has early dumping syndrome or late dumping syndrome. Signs of early dumping syndrome include:

• Nausea.
• Feeling full (even if you have only eaten a small amount).
• Severe diarrhoea.
• Abdominal pain and cramps.
• Sweating.
• Feeling light-headed and dizzy.
• Racing heartbeat.

These symptoms tend to develop around 30 to 60 minutes following eating.

Symptoms of late dumping syndrome include:

• Tiredness and weakness.
• Racing heartbeat.
• Feeling hungry.
• Loss of concentration and confusion.
• Shaking and feeling dizzy and faint.
• Sweating.

These symptoms usually develop around 2-3 hours after eating.

How is rapid gastric emptying diagnosed?

Rapid gastric emptying is usually diagnosed according to warning signs in individuals who have recently undergone gastric surgery. However, assessments may be required to rule out conditions with similar symptoms.

Treatment for rapid gastric emptying

Treatment usually involves making changes to your diet and avoiding certain foods. Most people find that cutting out specific foods helps to prevent symptoms.

Foods to avoid:

• Sugary foods (cakes, biscuits and sweets).
• Fizzy drinks.
• Pastries and sweet bread.
• Alcohol.
• Dairy products.

Foods to eat:

• Complex carbohydrates (pasta, rice and cereals).
• Fruit and vegetables.
• Plenty of water.

You may also be advised to take fibre supplements and change your eating habits. The following steps are often recommended:

• Eat small meals on a regular basis: try to eat 5-6 small meals, rather than 3 large meals.
• Chew your food well and cut it up into small, manageable pieces.
• Have a drink around 30-60 minutes after eating, rather than with your food.
• Replace sugar with sweeteners.
• Stop eating when you start to feel full.
• Have smaller portions.

If symptoms are more severe or persistent your doctor may prescribe medication or recommend surgery, but in the majority of cases these treatments will not be required.

Preventing dumping syndrome

If you have undergone gastric surgery your care team will advise you about eating and drinking after the procedure. It is important to follow this advice carefully. The steps listed above will help to prevent you from experiencing symptoms related to rapid gastric emptying. If you do experience symptoms lying down may help to ease discomfort.