Relationship between gastric surgery, lactose intolerance, and dumping syndrome
Original hub request: My uncle underwent gastric surgery. Is there a chance of him developing lactose intolerance? What is Dumping Syndrome?
Yes friend your uncle is at risk of developing lactose intolerance and dumping syndrome if he has undergone gastric surgery recently but it depends from person to person as some patient experience these and some only experience acidity and GERD or in medical words gastroesophageal reflux disease.
For answering your question in more detail, I am writing out this hub to guide you and other people in food and nutrition related to modified diet in carbohydrates and to improve nutritional care of patients suffering from lactose intolerance and dumping syndrome because improving and modifying the patient's diet accordingly helps a lot.
I am providing this information only for instructional purposes and for better guidance and proper care, please consult a good gastroenterologist or gastric surgeon in your area.
Modified diet in carbohydrates
Operations in the stomach that sacrifice gastric tissue and alter the mechanism of gastric emptying can sometimes cause changes in gastrointestinal physiology and long-term effects causing syndromes like dumping syndrome postgastrectomy or consist of a variety of pathophysiological disorders. Dumping syndrome is an English phrase to describe the sudden filling of the small intestine due to the emptying spout or blow on the stump resulting from gastrectomy.
There are two components of this complex pathophysiological disorder: vasomotor and gastrointestinal. Symptoms include weakness, palpitations, agitation, sweating, paleness, fainting, mental confusion and rarely syncope. Gastrointestinal symptoms include abdominal pain, nausea, vomiting and diarrhea during or immediately after food intake. Humoral factors are released into the intestine after hypertonic rapid transit of food, especially carbohydrates (foods high in sugar) from the stomach into the small intestine. The syndrome arises from the rapid penetration of hyperosmolar fluids in the intestine. Some patients suffer from mild form about 20% of gastroduodenal ulcer surgery, but is clearly annoyed at 7% of cases.
In the postprandial period (2 to 4 hours), some patients (10%) may suffer from hypoglycemia. These patients show rapid increases in blood sugar and insulin levels. These symptoms are often most apparent in the first month after surgery and decrease over a time period.
Furthermore there are aberrations involving complex physiological electrolyte changes in renal blood flow and plasma volume.
Fortunately, 75% or more of patients experience unsatisfactory results of the processes after gastric surgery and 25% of people experience some degree of dumping symptoms that can be controlled to a greater instance by dietary measures.
Dietary treatment aims to reduce the volume and the osmotic effect of the food that enters the small intestine thereby preventing proximal small bowel distension and delayed hypoglycemia.
The aim of diet therapy is to reduce gastric and lower work while intestinal overload. For this, food starts with a regime insufficient energy and nutrient intake of small volume, increased progressively to meet the energy needs. These patients may suffer from malnutrition due to malabsorption and presenting symptoms.
Patients should be given foods rich in protein and fat (because both nutrients stimulate gastrin secretion which in turn slows gastric emptying). Should be restricted in carbohydrates (no simple sugars, mono and disaccharides, for its rapid absorption), and avoid drinking fluids with meals (limited to 1 hour before or after meals).
A very important aspect is that these patients should consume little heavy, frequent meals with solid foods. Make 6 meals: breakfast, snack, lunch, snack, lunch and dinner with an Energy or Calorie Percentage Distribution (CPD) for 15, 15, 20.15, 20.15% respectively and on day Protein: 20% Carbohydrates: 50% Fat: 30%.
Because lying can slow gastric emptying, the patient must lie down for 30 minutes after meals.
Because the symptoms vary considerably in severity and duration, the diet should be individualized and modified as per the patient's symptoms.
Diet is proposed according to the patient's energy needs and nutritional status.
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What is lactose intolerance?
The lactose tolerance varies from one individual to another. A patient may experience symptoms after ingestion of lactose as abdominal pain, cramping and diarrhea, because if the enzyme lactase is deficient to hydrolyze the lactose ingested, is part of lactose in the intestinal lumen and through an osmotic effect draws water into the intestinal lumen, causing the symptoms described above. The severity of symptoms depends on the amount of lactose ingested and the level of lactose intolerance.
There may be a secondary lactase deficiency in patients with acute or chronic diseases that damage the intestine as tropical or celiac sprue, or Crohn's disease, or who have undergone gastric surgery or small bowel resection.
In periods of absolute rest as the gastrointestinal tract during the use of parenteral nutrition may be produced atrophy of the microvilli of the small intestine and therefore, lactase deficiency, usually achieved functional recovery of these changes through gradual onset of dietary intake for several weeks.
A doctor provides a nutritionally adequate diet and reduces symptoms to a minimum or at a level tolerable for the patient.
A doctor sets the level of individual tolerance by adding small amounts of foods containing lactose, a lactose-free diet. Most people can tolerate lactose 5.8 grams in one dose, amount to a half-cup of milk or equivalent.
Usually can eat small amounts of lactose, divided into several doses throughout the day and is better tolerated if accompanied by other foods.
The yogurt may be better tolerated than milk because of the lactase bacteria present in the crop of lactose hydrolyzed yogurt in addition to the hydrolysis, which occurs in the intestinal tract. You can eat soy yogurt, which is a protein food of plant origin.
Cocoa and chocolate milk may be better tolerated than milk alone, by increasing the thickness of fat and ingesting it, although there is individual variability.
Lactose free food
Natural Meat, fish, poultry, peanut butter
Breads containing no milk, dried milk solids or whey
Fruits, vegetables natural
Desserts without milk, dried milk solids or whey
Tofu and derivatives
Foods low in lactose (0-2% / PORTION)
1 / 2 cup milk treated with lactase
1 / 2 cup sorbet
Cheese cured 30-60 grams
30 grams processed cheese
Commercially prepared foods containing derivatives
Milk or whey solids.
Foods high in lactose
All kinds of milks