Post-Gastrectomy Diet (anti-dumping)

What are the symptoms of the dumping syndrome?

The dumping syndrome occurs in some patients who have undergone stomach surgery. The symptoms include bloating, nausea, diarrhea, dizziness, weakness, sweating and rapid heartbeat. They may occur 30 to 60 minutes after eating a meal and then again, 2 to 3 hours after eating. The early symptoms are caused when concentrated sugar passes too rapidly from the stomach into the intestine.

What is the scientific explanation of the dumping syndrome?

The body dilutes this sugar mixture by bringing fluid from the body tissues into the intestine, giving a sense of fullness, cramping and occasionally diarrhea. The loss of water from tissues can produce a temporary drop in blood pressure, with resulting weakness and faintness. The latter symptoms are caused by the rapid absorption of sugar into the blood stream, which raises the amount of blood sugar. A high level of blood sugar signals the body to produce more insulin. The excess insulin, in turn, drives blood sugar levels down. The low blood sugar (hypoglycemia) produces the weakness, hunger and rapid heart rate that may occur about 2 to 3 hours after eating.

What is an anti-dumping diet?

This diet is really a regular diet with frequent small meals and reduced simple sugars. Depending upon individual tolerance and food selection, the Anti-Dumping or Post Gastrectomy Diet is adequate in all nutrients according to the National Research Council’s Recommended Dietary Allowances (RDA). Depending on the type and extent of gastric surgery performed, poor absorption of nutrients, vitamins and minerals may occur to a significant degree. Some patients may become deficient in iron, calcium, folate and B-12. The physician may prescribe vitamin/mineral supplementation and B-12 injections.

What are the general recommendations of this diet?

  1. Eat six small meals daily to avoid overloading the stomach.
  2. Limit fluids to 4oz (1/2 cup) during mealtimes. This prevents the rapid movement of food through the upper gastrointestinal tract and allows adequate absorption of nutrients.
  3. Drink liquids 30 to 40 minutes before eating and 1 hour after eating, rather than with meals.
  4. Rest or lie down for 15 minutes after a meal to decrease movement of food from the stomach to the small intestine. This decreases the severity of symptoms.
  5. Avoid sweets and sugars. They aggravate the dumping syndrome.
  6. Avoid very hot and cold foods or liquids, which may increase symptoms in some patients.
  7. Stomach surgery is performed for different reasons, so calorie requirements may vary from patient to patient who has had surgery for severe obesity will need to be on a weight reduction program, A very thin patient who has had ulcer or cancer surgery will need extra calories.

 FOOD GROUPS

Group

Recommend

Avoid

Milk or 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 fruit 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 & gains

(4 or more servings daily)

Crackers; pasta; plain breads and rolls; pretzels; rice; unsweetened cereals

Sugar-coated cereals (including granola); doughnuts; sweet rolls

Meat or meat substitute

(5 to 6oz daily)

Eggs; seafood; beef; poultry; pork; peanut butter

None

Fats & oils

(servings depend on caloric needs)

Butter; margarine; oils; salad dressing

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 fluids with meals to 4oz 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

Breakfast

Lunch

Dinner

Unsweetened orange juice ½ cup

Poached egg 1

Toast 1 slice

Margarine 1 tsp

Low calorie jelly 1 tsp

Salt/pepper

Beef patty 3oz on bun

Mayonnaise or ketchup 1 Tbsp

Broccoli ½ cup

Margarine 1 tsp

Skim milk ½ cup

Salt/pepper

Chicken breast 3oz

Mashed potatoes ½ cup

Green beans ½ cup

Margarine 2 tsp

Coffee ½ cup

Non-dairy creamer

Sugar substitute

Salt/pepper

Mid-Morning Snack

Mid-Afternoon Snack

Evening Snack

Unsweetened cereal ½ cup

Skim milk ½ cup

Bread 1 slice

Turkey 1oz

Mayonnaise 1 Tbsp

Lettuce

Low calorie pudding ½ cup

Cottage cheese ¼ cup

Fresh peaches ¾ cup

 

THIS SAMPLE DIET PROVIDES THE FOLLOWING

Calories

1550

Fat

62 gm

Protein

87 gm

Sodium

2327 mg

Carbohydrates

119 gm

Potassium

2372 mg