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Dumping without WLS? TMI Alert

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Old 01-20-2010, 02:39 AM   #1
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Default Dumping without WLS? TMI Alert

This may sound crazy, but ever since I had my gallbladder out I have had extreme diarrhea every day every time. I was on Cholestyramine for about a year, but the bloating and cramps were worse than the minimal help it offered. I am now in a cycle where I have moderate (what I think are) intestinal cramps until I eat, pain abates while eating, severe intestinal pain after eating and ahem, um, complete disposal of everything I had eaten within one hour with the ability to see some of the undigested meal in the um, poo.

Anybody get through all that and have any idea whether this dumping syndrome I had heard of after wls can apply if you have not had that surgery but may have had portions of your gastrointestinal system altered during gallbladder surgery?
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Old 01-20-2010, 03:19 AM   #2
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My mom had her gall bladder out and she has that problem, especially with particularly rich foods or leafy green vegetables. Sorry you have to deal with that :-(
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Old 01-20-2010, 06:12 AM   #3
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I've dealt with this type of issue, even with an intact GB (though I wouldn't guarantee mine's in great shape). My mother had her GB out several years ago, and her GI issues worsened greatly.

In my case, it seems to be linked to eating foods with higher fat content than I'm accustomed to, or more volume than I'm accustomed to (a large salad may cause too much GI "stretch" and result in maldigestion for me).

I have had good success with a couple things: peppermint oil capsules, and probiotics. After a lot of consults with various docs and GI specialists, I was basically given a general "irritable bowel" label and told that I'll essentially just have to deal with it. So (as many do), I turned to google and heard a lot of wacky advice (but some useful). Peppermint is supposed to sooth and help relax the GI tract (as long as it's enteric-coated, so that it survives the stomach and some can reach the SI), and the probiotics help replenish the bacterial load, providing digestive function and limiting access for pathogenic bacteria. These, along with limiting fatty foods and not eating too much volume at once, tend to keep me pretty stable and no longer running for a bathroom as soon as I eat.

I realize some folks might consider supplements to be quackery or otherwise less than ideal (and I tend to use a lot of discretion before just popping whatever), but that's what's worked for me. It took about a month for me to see much of a trend with the peppermint, but it did help limit the number and severity of attacks. And after about 3 months on daily probiotic supplements, I found I could taper off the peppermint and allow my gut to do its own thing, since it was well-seeded. After a lot of dietary indiscretion (like a ton of holiday gatherings with heavy foods and alcohol), I've found a couple weeks of probiotics helps get things back in line again.

Let me know if you'd like specifics on what worked for me. And good luck - I know what it's like to be unsure if you can eat anything at all, and sometimes doctors either assume you're exaggerating or don't have any advice.
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Old 01-20-2010, 11:47 AM   #4
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You do have to drastically cut your fat consumption. No vegetables bother me, but after 37 years, if I have a meal too high in fat, I'm in the bathroom quick. I also cannot tolerate too many starches and sugar only in a very limited quantity. Meat, fruits, veggies, dairy doesn't bother me.
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Old 01-26-2010, 03:21 PM   #5
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I had my GB out 10 years ago and developed this pattern of "dumping" also. It didn't seem to matter what I ate, even the blandest foods would cause me horrible cramping and diarrhea. I too was labeled with IBS and told to avoid my "triggers" - but I could never fully identify them. It wasn't always rich foods. Things like crackers or plain pasta would tear me up.

After a particularly horrific week of flaring stomach, cramps, and living in the bathroom I made an appt with my new General Doc. He suggested I cut out all gluten and that what I described sounded more like non-tropical sprue, celiacs disease or gluten intolerance. Celiacs is genetic and tends to run in families with a history of it. Sprue/intolerance can pop up any where and at any point in a persons lifetime and is most often triggered by a trauma, stress, or illness.

I cut out all gluten (anything derived from wheat, barley, or rye) and felt immensely better in less than 2 weeks. I looked better too. People around me noticed I was no longer sallow and looked "healthier" and my mood improved. I had genetic testing to rule out Celiacs and antibody testing to look for elevated immunogloblin levels. I do not have Celias Disease, but I am gluten intolerant. I had basically been poisoning myself with wheat products for the past decade.

It may not be the case for you, but I know what it feels like to be in that pain and be willing to try anything to get relief. A gluten free diet is not as convenient, but it's manageable. It makes resisting birthday cake at the office and holiday cookies easier knowing that not only will is contribute to my waistline, but it will have me tied to the toilet for the next 24-48 hours.

Good luck,
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Old 01-26-2010, 08:29 PM   #6
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IBS is the ususal diagnosis given for any of us who have chronic diarrhea; never heard it called dumping before. I had very severe gas, cramping/pain, and what we affectionately called "THE FOX TROTS" for years; and it started in my teens and lasted until my forties.

I found that the only thing that helped me was "STRAWBERRY EXTRACT" -- the PURE sugarless extract, not the new creamy one: it helps, but the pure extract is better. This worked the fastest and best to relieve my severe symptoms ...

It appeared like too much dairy and chocolate cake (which I rarely eat so we think it was the sugar & fat); and STRESS were big triggers for me; and lots of veggies, which don't digest in my system at all. Over time, my symptoms got better. I still eat veggies and salads even though they still don't all digest, but I don't have the diarrhea very much any more.

I vary and limit my wheat and grains, so that may have helped some too. If I do have ice cream on occasion; I only have 1/2 cup serving which doesn't bother me anymore; and I would often have the low fat yogurt ice cream. I think for me it was what and how much. As I have gotten older, now I am swinging between a more normal BM and the other extreme: constipation; and that feels almost as bad. How's that for not too funny ...

I hope you find something that will help you feel better soon -- it may take a bit of trial and error, as it did for me.
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Old 01-27-2010, 02:21 PM   #7
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I can speak personally and professionally about diarrhea post-cholecystectomy. First of all, this is not the same as "dumping syndrome", which is rapid transport of undigested food from the stomach to the small intestine. Here is info from the National Institutes of Health on dumping syndrome http://digestive.niddk.nih.gov/ddise...ndex.htm#cause

Diarrhea after gallbladder removal (had mine removed 4 months ago) is very common and due to the fact that the liver has to learn how to handle bile without a gallbladder to store it. After you eat, the liver releases bile salts now directly into the small intestine and can overwhelm the gut's ability to absorb them resulting in diarrhea. That's why meds like cholestyramine are tried - in the hopes that these excess bile salts will be bound up.

I had dreadful diarrhea for about 2 months - almost unable to leave the house. Turns out the antibiotic I was given as normal part of preop procedure was the cause. With treatment and increasing fiber in my diet (I use Benefiber) plus use of probiotics to restore my normal gut bacteria, I finally am at a place where I only occasionally get the OMG diarrhea.

You should talk with your surgeon about persistence of your symptoms. He/she will probably blow it off to "post-cholecystectomy syndrome" meaning - "gosh, you have gastrointestinal symptoms that I can't explain after I operated on you and can't find anything to fix." He/she might do some other tests on your upper GI system.

Try increasing bulk in your diet; eating smaller more frequent meals; AND DO NOT TAKE THIS AS MEDICAL ADVICE.

I'm incredibly sympathetic to your plight, pursue this with your surgeon, then your internist/family doc.

Last edited by Sskar : 01-27-2010 at 02:22 PM.
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