GIST Support Wiki"Dumping" refers to the sudden rise and then drop of blood sugar levels. This in turn causes symptoms such as diarrhea, bloating, nausea, dizziness, weakness, sweating, and rapid heartbeat.
Dumping especially affects people whose gastrectomy has either impaired the function of the valve between the stomach and the intestines or been removed entirely. Without this valve, the sugar you ingest flows directly into your intestines - where it is rapidly absorbed into your bloodstream. This causes you to be in a state of high blood sugar. Your body reacts to this by greatly increasing the output of insulin from your pancreas which rapidly brings down this blood sugar level so that you end up at the opposite extreme - in a state of low blood sugar. If you were a diabetic you alleviate this by eating or drinking something high in glucose, but this won't work if your valve has been removed. All you will end up doing is creating a bad cycle of high/low/high/low/high/low blood sugar which will make you all screwy. Suggestions for reducing dumping include:
- Avoid things with high sugar content, like soft drinks, milkshakes, candy bars, and (unfortunately) many of the "nutritional" drinks you get at the hospital from a dietician (which are often super heavy in sugar content). Drinking or eating these cold may make your dumping worse.
- Don't eat too much at once -- eat more frequent small meals
- Eat a varied diet
A diet plan, the Anti-Dumping Post-Gastrectomy Diet, as well as more detailed explanations of the causes of dumping, may be found at Jackson Siegelbaum Gastroenterology [1]
A medical paper on Dumping Syndrome by William L. Hasler, MD is free-access at the journal Current Treatment Options in Gastroenterology [2]
Did you have your stomach removed when you had your surgery? If not, do you know the cause of your dumping? My husband, who had his stomach removed along with his GIST in 2001, developed celiac disease after a hernia surgery a couple of years ago. At the same time he became lactose intolerant. He had a terrible time with dumping until we figured out that he couldn't eat dairy. Dairy and sugar together almost always cause dumping in someone without a stomach, and the celiac disease means that gluten was destroying the villi in his small intestine, which was also causing diarrhea. There are narcotics that are stronger than Imodium that your doctor could prescribe to deal with the dumping if it isn't related to dairy, but I would want to also find out what's causing it. A lot of people are given Lomotil for that problem.
I find that it can be difficult to differentiate between nausea and loose bowels caused by dumping syndrome (due to the gastrectomy) or caused by gleevec. My dumping syndrome was the worst during the first 2 years post-op. It consisted of sudden onset nausea and diarrhea, and even a cold sweat and heart palpitations at times. The thing that would usually trigger this was ingesting refined sugar, especially in liquid form. Coffee would (and still does) tend to bring it on, but I refuse to give up my morning coffee. I found that it was helpful to use artificial sweetener rather than sugar in my coffee. The thing that helps the most when I experience dumping syndrome is to lie down on my right side. This usually resolves the problem within a minute or so by slowing the rate of emptying of my stomach which no longer has a valve at the bottom of it. I don't know why I have to lie on my right side, but it does seem to make a difference.