You’re developing the plan of care for a patient experiencing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include?
A. Omit fluids with meals.
B. Increase carbohydrate intake.
C. Decrease protein intake.
D. Decrease fat intake.
Correct Answer: A. Omit fluids with meals.
Gastric emptying time can be delayed by omitting fluids from your patient’s meal. A diet low in carbs and high in fat & protein is recommended to treat dumping syndrome. Most cases of dumping syndrome are successfully treated with dietary adjustments. The suggested division of meals recommended is at least six times per day. Liquids should be withheld until 30 minutes after the meal.
Option B: In addition, simple sugars and milk products should be avoided. Protein and fat calories should be increased to compensate for the decreased carbohydrate intake. Fiber-rich food is encouraged and has shown to promote a longer transit time in the bowel.
Option C: Increase protein intake. 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, resulting in weakness and faintness.
Option D: Increase fat intake. 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. Low blood sugar (hypoglycemia) produces 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.
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