Expert: Karla K. - 12/9/2007

Question
Hi,

On Nov 7th I had gastric bypass surgery and my surgeon bypassed 150 cm of my intestines.  Over the holidays I gave in to temptation and had a spoon of ice cream.  I noticed I did not dump.  Then I wanted to experiment and see if I would dump if I had a piece of cake.  I didnt dump then either.  

Based on your experience as a gastric bypass patient is there a certain amount of fat/sugar I'd need to consume in order for dumping to occur.  While I've vowed to stay away from any more sweets/fattening foods I was looking forward to the negative reinforcement.  I'm concerned that the procedure isnt working as it should.  If I dont dump, does that mean I'm absorbing all of what I consume?

Your insight is most appreciated.

Thanks!

Answer
Hi Linda:

Not everybody who has a gastric bypass dumps (best data I can find says about 75 percent do).  Even those who do experience dumping, may lose that phenomenon roughly one year post-op.  The good news is that lack of dumping does not equal lack of weight loss success.  

A study in 1996 showed that "Among gastric bypass patients, no relationships were found between severity of dumping and weight loss, as measured by per cent of excess body weight loss or change in body mass index."  http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSear...

The reason you dump has to do with the fact that your pyloric sphincter/valve at the bottom of your stomach was bypassed when they created your Roux-en-Y pouch.  The pyloric valve regulates the rate at which food leaves the stomach and enters the small intestines.  Because you no longer have this regulatory mechanism, food leaves your pouch and is "dumped" into your small intestines quite quickly.  When one consumes a meal high in refined carbohydrates, this causes dumping syndrome in many gastric bypass patients.  

The malabsorptive part of your operation is still working regardless.  The malabsorptive bit has to do with the fact that 150 cms of your intestines no longer come into contact with the food you eat--so, there is less surface area for the intestines to absorb calories and nutrients.  Because of this, as I'm sure you know, you need to take the vitamins your surgeon prescribed for life--as well as have regular bloodwork.  

Right now is a golden opportunity for your weight loss.  You also should be experiencing reduced physical hunger due to the decrease in ghrelin production from your operation.  That, combined with the malabsorptive portion of your operation, give you a wonderful chance for success.  As I'm sure you know, once you have the green light from your surgeon to eat solid foods--eat protein first, followed by non-starchy vegetables and fruits, and then carbohydrates.  If you do this most of the time, as well as exercise, you will be successful.  

I hope this helps!
Karla