Anti-Dumping Post-Gastrectomy diet is a particular variety of diets used to avoid the risk of dumping syndrome. Dumping syndrome affects individuals after gastric surgery(1). The severity of symptoms may vary from person to person depending upon the type of surgery and extent of tolerance to diet.
However, the common symptoms(2) experienced in dumping syndrome are diarrhea, bloating, nausea, sweating, weakness, dizziness, and tachycardia.
The symptoms usually appear after 30 minutes to one hour after the last meal and again appear after 2 to 3 hours after eating.
The early symptoms occur due to concentrated sugars that rapidly move from the stomach to the intestine. Sugars in the intestine exert their osmotic effect and draw water into the intestine. As a result, sugars in the intestine are diluted. However, there is a sense of fullness, cramping, and occasionally diarrhea also occurs. As water is drawn into the intestine, body tissues become dehydrated, and blood pressure also falls, resulting in weakness and faintness(3). The later symptoms of dumping syndrome are due to the rapid absorption of sugars from the intestine into the blood, raising blood sugar levels.
As blood sugar level increases, the body produces a high amount of insulin, which reduces blood sugar level. The reduction in blood sugar level produces the sensation of weakness and hunger. These symptoms appear after 2-3 hours after the last meal.
Nutrition Facts:
Depending upon individual tolerance, food selection, and type of surgery performed, the Anti- Dumping Diet can be taken so that all essential nutrients are present in it according to their Recommended Dietary Allowance (RDA) and the disease symptoms are avoided(4). Some minerals and vitamins may be absorbed poorly after gastric surgery, such as iron, calcium, folate, vitamin B-12, etc. In this case, the physician may prescribe mineral or vitamin supplementation.
Special Consideration Regarding Anti-Dumping Diet:
- Adopt eating 5 to 6 small meals instead of three large meals to avoid stomach overloading.
- Limit fluid intake up to 1/2 cup during the meal. Excess fluid speeds up the movement of gastric contents from the stomach to the small intestine. Conversely, a decrease in fluid intake slows down the movement of gastric contents.
- Adopt the habits of drinking fluid 30-45 minutes before and 1 hour after a meal.
- Lie down after taking a meal as it slows down the movement of gastric contents to the small intestine and relieves the symptoms.
- Sugars and sweet foods should be avoided as they aggravate the condition.
- You should avoid very hot or cold food if it aggravates the symptoms.
- Take care of your calorie intake to maintain optimum body weight.
Food Groups
| Milk & milk products (2 or more cups daily) | as tolerated: butter- milk, low fat, skim, or whole milk, creamed soups, low calorie pudding, plain or low-calorie, artificially sweetened yogurt; cheese | cocoa mixes, ice cream, malted or chocolate milk, sweetened custard and pudding, sweetened, fruited, or frozen yogurt, milkshakes |
| Vegetables (3 or more servings daily) | all | none |
| Fruits (2 or more servings daily) | fresh fruit, fruit canned in natural juice, unsweetened fruit juice | dried fruits, canned or frozen fruits in syrup, sweetened juice |
| Breads & grains (4 or more servings daily) | crackers, pasta, plain breads and rolls, pretzels, rice, unsweetened cereals | sugar-coated cereals (including granola), doughnuts, sweet rolls |
| Meats & meat substitutes (5 to 6 oz daily) | eggs, seafood, beef, poultry, pork, peanut butter | none |
| Fats & oils (servings depend on caloric needs) | butter, margarine, oils, salad dressings | none |
| Sweets & desserts (servings depend on caloric needs) | artificial sweeteners, low-calorie jelly, low- calorie gelatin, low- calorie popsicles | popsicles, cakes, pies, cookies, jellies, jams, gelatin, high sugar desserts, sherbet |
| Beverages (limit fluid with meals to 4 oz per meal) | sugar-free beverages, water | regular soft drinks, sugared drink mixes, lemonade, Kool Aid, Gatorade, sugared ice tea, Snapple or similar drinks |
Sample Menu
|
unsweetened orange juice 1/2 cup poached egg 1 toast 1 slice margarine 1 tsp low-calorie jelly 1 tsp sugar substitute salt/pepper |
beef patty 3 oz on bun mayonnaise or ketchup 1 Tbsp broccoli 1/2 cup margarine 1 tsp skim milk 1/2 cup salt/pepper |
chicken breast 3 oz mashed potatoes 1/2 cup green beans 1/2 cup margarine 2 tsp coffee 1/2 cup non-dairy creamer sugar substitute salt/pepper |
| Mid-Morning Snack | Mid-Afternoon Snack | Evening Snack |
|
unsweetened cereal 1/2 cup skim milk 1/2 cup |
bread 1 slice turkey 1 oz mayonnaise 1 Tbsp lettuce low-calorie pudding 1/2 cup |
cottage cheese 1/4 cup fresh peaches 3/4 cup |
This Sample Diet Provides the Following
| Protein | 87 gm | Sodium | 2327mg |
| Carbohydrates | 119gm | Potassium | 2372mg |
References
- Berg P, McCallum R. Dumping Syndrome: A Review of the Current Concepts of Pathophysiology, Diagnosis, and Treatment. Dig Dis Sci. 2016 Jan;61(1):11–8.
- Scarpellini E, Arts J, Karamanolis G, Laurenius A, Siquini W, Suzuki H, et al. International consensus on the diagnosis and management of dumping syndrome. Nat Rev Endocrinol. 2020 Aug;16(8):448–66.
- Mala T, Hewitt S, Høgestøl IKD, Kjellevold K, Kristinsson JA, Risstad H. [Dumping syndrome following gastric surgery]. Tidsskr Nor Laegeforen. 2015 Jan 27;135(2):137–41.
- van Beek AP, Emous M, Laville M, Tack J. Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management. Obes Rev. 2017 Jan;18(1):68–85.
