Anti-Dumping Post-Gastrectomy Diet

Author:  Frank W. Jackson, M.D.

Purpose

This diet helps to prevent a condition called “dumping syndrome,” which 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. The body dilutes this sugar mixture by bringing fluid from 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 later symptoms are caused by the rapid absorption of sugar into the bloodstream, 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 two to three hours after eating. This diet is really a regular diet with frequent small meals and reduced simple sugars.

Nutrition Facts

Depending upon individual tolerances 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.

Special Considerations
  1. Eat six small meals daily to avoid overloading the stomach.
  2. Limit fluids to 4 oz (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 45 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 or 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. For example, a 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 & 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
Breakfast
Lunch
Dinner
  • 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
Calories
1550
Fat
62 gm
Protein
87 gm
Sodium
2327 mg
Carbohydrates
119 gm
Potassium
2372 mg

© Frank W. Jackson, M.D.