Diabetic Gastroparesis

Gastroparesis is simply defined as a partial paralysis of the stomach caused by damage to the vagus nerve which can be caused by Parkinson's disease, Diabetes or stroke and in some instance by medications such as calcium channel blockers, certain narcotics or antidepressants.

Symptoms of Gastroparesis may include:

• A feeling of fullness after only a few bites of food.
  
• Frequent bloated feeling.
  
• Belching and hiccups.
  
• Heartburn or vague stomach pain.
  
• Nausea or vomiting.
  
• Loss of appetite and weight loss.

Everyone has different symptoms, ranging from extremely mild to extremely severe. Severe symptoms are often treated with motility agents (such as domperidone, metoclopramide or erythromycin) and if this fails, a feeding tube may be placed in the small intestine.

For diabetics with uncontrolled blood sugar levels, getting the blood sugar levels back to normal may help with the symptoms of Gastroparesis. For those who have symptoms, your doctor will most likely conduct a radioisotope gastric emptying scan where you will eat or drink something containing a radioactive substance that will show up in an image allowing your doctor to determine how quickly the food (or liquid) leaves your stomach.

Controlling Diabetic Gastroparesis

For those who are diabetic, Gastroparesis can make blood glucose levels much more difficult to control because the food that remains in the stomach is absorbed into the small intestine causing blood glucose levels to rise. Because Gastroparesis makes digestion unpredictable, this can create issues with diabetes medication schedules. For diabetics, with Gastroparesis who need to control blood glucose, they may need to:

• 
  take insulin more often or change the type of insulin taken


• take insulin after eating instead of before
  
• Check blood glucose levels frequently after eating and administer insulin as needed.

If you are diagnosed with Gastroparesis and are diabetic, discuss your need with your doctor who will be able to give you more specific directions.

Treatment for Gastroparesis may include:

• Not eating three large meals, but several smaller ones;
• Low fat and fiber meals;
• a motility treatment;
• In severe cases, a feeding tube being placed in the intestine.

Another potential danger is that the food staying in the stomach can cause a bacterial growth that turns into masses called 'bezoars' which can cause not only nausea and vomiting but may also cause an obstruction in the stomach and can block food from entering the small intestine.

Things To Remember With Gastroparesis:

• Gastroparesis is caused by damage to the vagus nerve and causes food to be retained in the stomach
• People with Type 1 or Type 2 diabetes may suffer this more often due to damage caused by high glucose levels
• If you suffer ongoing symptoms such as fullness (in spite of eating small quantities of food) gastroesopageal reflux, lack of appetite and weight loss, accompanied by other symptoms of Gastroparesis - contact your doctor immediately

Treatment may include: dietary changes, oral medications, adjustments in insulin injections for people with diabetes, a jejunostomy tube, parenteral nutrition, gastric neurostimulators, or Botulinum toxin.