Gastroparesis and the Diabetic
Gastroparesis is also called delayed gastric emptying. It is a disorder of the stomach. What happens in the stomach is that it takes too long for stomach contents to empty. This typically occurs when the vagus nerve is damaged and the muscles of the stomach and the intestines are not working properly. This results in food moving more slowly than normal or even stopping all together as the food makes its way through the digestive tract.
There are many causes for gastroparesis including surgery on the stomach or vagus nerve which has caused damage to the vagus nerve, viral infections, anorexia nervosa or bulimia, medications that slow contractions in the intestine, gastroesophageal reflux disease, smooth muscle disorder, nervous system diseases, including Parkinson’s disease, and metabolic disorders, such as hypothyroidism. Sometimes the cause for gastroparesis, is unknown despite testing.
The symptoms for gastroparesis are heartburn, pain in the upper abdomen, nausea, vomiting of undigested food which may occur hours after eating the food, feeling full after eating only a few bites of food, weight loss due to poor absorption of food, abdominal bloating, high and low blood glucose levels, a lack of appetite, gastroesophageal reflux, and also spasms in the stomach area.
When individuals with gastroparesis consume solid foods, or foods high in fiber such as raw fruits or vegetables, or fatty foods and also drinks or food that is high in fat or drinks that contain carbonation can increase the occurrence of these symptoms.
These symptoms of gastroparesis can be mild or they can be severe, depending on the individual and the degree to which the disease has occurred.
When food lingers too long in the stomach bacterial overgrowth from the food fermenting can occur. Food can also harden into solid masses called bezoars that may then cause nausea, vomiting or an obstruction in the stomach. The appearance of bezoars can be dangerous if they block the passage of food into the small intestine.
Gastroparesis can make diabetes worse because it can make the blood glucose control difficult. The blood glucose levels can be erratic due to the unpredictable occurrence of the food emptying from the stomach and entering the small intestine. Gastroparesis can be diagnosed by having the following tests performed: An upper endoscopy, an ultrasound and a Barium x-ray.
If gastroparesis is suspected then gastric emptying tests may be performed including gastric emptying scintigraphy, a breath test, and the SmartPill device may be used to collect information about its progress through the digestive tract.
If you are diabetic and diagnosed with gastroparesis the treatment plan will include dietary changes, perhaps changes to your insulin, or other medications, and in severe cases you may need to have a feeding tube or parenteral nutrition. You may need to take insulin more often, or change the type of insulin you are taking. You may need to take insulin after you eat instead of before eating as normal. You will have to check your blood glucose levels more frequently after you eat and also may have to administer insulin whenever it is necessary depending on your glucose readings.
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