Diabetic gastroparesis is a potential complication of chronically high blood sugar levels where the stomach muscles don’t contract normally. It slows the speed that food moves from the stomach to the intestine, known as gastric emptying, and it can cause severe gastrointestinal discomfort.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292c585a17-848c-418b-97cf-eeebd825c9f4 Diabetic gastroparesis may develop in as many as 10 percent of people with diabetes, and can affect those with both type 1 and type 2 diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629326080f7-c87d-4506-b3a9-3a5a43114ead There is no cure, but diabetic gastroparesis can be managed with lifestyle changes and medications. In severe cases, surgery may be recommended.
Signs and Symptoms of Diabetic Gastroparesis Symptoms Delayed gastric emptying from diabetic gastroparesis can cause many severe digestive symptoms, including:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299745885c-2338-419f-b695-dd96dd52533e Vomiting Bloating Abdominal pain Heartburn Loss of appetite or feeling full after eating very little Blood sugar fluctuations Weight loss
Causes and Risk Factors for Diabetic Gastroparesis Causes In people with type 1 or type 2 diabetes, gastroparesis can occur if the vagus nerve , which helps control the digestive system and other essential bodily functions, is damaged by unhealthy blood sugar levels. It typically develops in those who’ve been living with diabetes for at least 5 or 10 years.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6d47811-c98d-45b6-a33d-fe2c97f3ef92 “This nerve damage affects the stomach’s natural rhythm of contractions, leading to gastroparesis,” says gastroenterologist Bryan Curtin, MD , the director of the center for neurogastroenterology and GI motility at Mercy Medical Center in Baltimore. Essentially, the muscles in the wall of the stomach don’t function the way they should, causing a delay in gastric emptying.e60dc2a1-f33c-4a05-9b50-8e3e8e59762917534b13-66b1-4234-846b-98fab87632d3 According to Michael Cline, DO , the medical director of the gastroparesis clinic at Cleveland Clinic, people with gastroparesis almost always have other complications before developing gastroparesis, including nerve damage in the feet and legs and eye or kidney issues. Gastroparesis can also be the result of abdominal surgery or viral illness, and certain medicines can make it worse.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d56e5537-8073-40e8-b0f5-a2478d37d2ce
How Is Diabetic Gastroparesis Diagnosed? Diagnosis Your doctor will test you to confirm you have diabetic gastroparesis and rule out other causes of gastrointestinal discomfort. The options include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294629fe3e-1a19-416e-82eb-62267dc41dd0 Upper Gastrointestinal Endoscopy Dr. Cline says this procedure can identify a partial blockage or anatomy problem that prevents the stomach from emptying. An endoscopy involves placing a long, flexible tube with a camera attached into the esophagus, stomach, and duodenum, which is the first part of the small intestine beyond the stomach. Ultrasound This imaging test also identifies blockages or anatomy issues, and it uses high-frequency sound waves to create images of organs and tissues inside the body. Scintigraphy This is the next diagnostic step if no blockages or anatomy problems were discovered. It measures how quickly your stomach empties food into the intestine. You eat a light meal that contains a small amount of radioactive material. Then, a technician uses a specialized camera to scan the radioactive material and process it into images. You will be scanned right after you eat, 30 minutes later, and one, two, and four hours later.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bc807156-5435-4674-bea5-76464f5fafa4
Dietary Changes for Diabetic Gastroparesis Dietary Changes Since this is a digestive condition, it’s essential to pay attention to which foods are recommended and what to avoid. Focus on low-fiber, low-fat, soft, and well-cooked foods. Research shows that spicy, acidic, and fatty foods can make symptoms worse. It may also be helpful to eat smaller, more frequent meals (four to five per day) that don’t contain much soluble fiber , which can be tough to digest. Grains, beans, and legumes all contain soluble fiber.e60dc2a1-f33c-4a05-9b50-8e3e8e597629df0a2b41-b6db-4148-ba22-547b9f6e2aac If you’re concerned that eating for gastroparesis might be difficult with the dietary restrictions you already follow to manage blood sugar, your healthcare team can help you create a healthy eating plan that will check all the right boxes.
Treatment and Medication Options for Diabetic Gastroparesis Treatment Controlling blood sugar levels through dietary changes like avoiding high-fat, highly acidic or spicy foods, insulin or other glucose-lowering medications, and physical activity is critical for people with diabetic gastroparesis. Beyond those core healthy behaviors, your doctor may prescribe additional treatments to manage symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977fddc78-6af7-4817-943f-f84c05897264 Medications Several types of medication can help the muscles in your stomach function properly, control nausea and vomiting, and reduce pain. Options include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762977fddc78-6af7-4817-943f-f84c05897264 Metoclopramide Metoclopramide increases stomach and intestine contractions and eases symptoms such as nausea, vomiting, heartburn, fullness after meals, and loss of appetite.e60dc2a1-f33c-4a05-9b50-8e3e8e597629270f0aae-6a2c-492e-83ee-65256ff7a39f This drug has a high risk for tardive dyskinesia if taken for longer than 12 weeks. Erythromycin This antibiotic helps the stomach muscles contract more to improve gastric emptying.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977fddc78-6af7-4817-943f-f84c05897264 The antibiotic azithromycin is sometimes used as an alternative. Antiemetics This class of drugs helps prevent and treat nausea and vomiting. Both prescription and over-the-counter (OTC) antiemetics are available, including dimenhydrinate (Dramamine) and bismuth subsalicylate (Pepto-Bismol).e60dc2a1-f33c-4a05-9b50-8e3e8e5976293a7ad80e-0110-4bb8-8a9a-edf7049ef262 Pain Relievers Your physician may recommend non-narcotic pain relievers for severe abdominal pain.e60dc2a1-f33c-4a05-9b50-8e3e8e59762977fddc78-6af7-4817-943f-f84c05897264 Medical Procedures and Surgery If your symptoms don’t improve with medication, your physician may recommend gastric electrical stimulation (GES). This procedure involves placing a small, battery-powered device under the skin in your lower abdomen and attaching wires to the stomach muscles. The device sends mild electrical pulses to the nerves and muscles in the stomach, helping stimulate contractions. If medications and GES aren’t helpful, you may need surgery. These surgical procedures modify the stomach to make it easier for food to pass to the intestine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc43778c-b91b-4662-bc39-aaf8a79a33a8 Pyloroplasty This procedure relaxes and expands the opening of the pylorus, the muscular valve that releases food from the stomach. Gastric Bypass Also offered as a weight loss surgery for people with type 2 diabetes who have severe obesity, a gastric bypass removes or closes off part of the stomach and creates a new channel between the stomach and small intestine.
Prevention of Diabetic Gastroparesis Prevention The best way to prevent diabetic gastroparesis is to keep your blood sugar within the target range recommended by your doctor.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a44fd8bd-6a53-4679-84bb-24144e8b288b The following strategies may be effective ways to do that:e60dc2a1-f33c-4a05-9b50-8e3e8e5976296dbba8e3-c302-40f7-8f29-d22868d08a1d Check blood sugar regularly. Take medicines as prescribed. Eat a healthy diet. Exercise regularly. Manage stress. Get enough sleep. Reach or maintain a healthy weight. Avoid tobacco products. See your doctor regularly.
Complications of Diabetic Gastroparesis Complications Because food lingers in the stomach, it can cause blood sugar levels to fluctuate unpredictably. Delayed gastric emptying can interrupt the release of sugar into your bloodstream, leading to hypoglycemia , also known as low blood sugar, especially if you use insulin before meals. Initial symptoms often include shakiness and a rapid heartbeat, but the condition can become life-threatening if not addressed. When food finally is released from the stomach into the small intestine, it could cause blood sugar to spike. Fluctuating blood sugar levels can make it challenging to control your diabetes, which can make it and your gastroparesis worse.e60dc2a1-f33c-4a05-9b50-8e3e8e59762910f625ed-c96a-4841-aad4-eb54cbb09e87 The symptoms of diabetic gastroparesis, including loss of appetite, nausea, and vomiting, can lead to dehydration and make it difficult to get the calories and nutrients your body needs to function.e60dc2a1-f33c-4a05-9b50-8e3e8e597629771e1a9d-269a-453a-bc77-bbbcc37efd8a Some food may not be digested at all. This food hardens into a bezoar, a solid mass that sits in the stomach and may cause nausea and vomiting, or even prevent other foods from passing into the small intestine.
Related Conditions Related Conditions Diabetic gastroparesis can increase your risk of other digestive conditions, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f1a817f7-8b46-402a-a2b4-7224d83130f5 Gastroesophageal Reflux Disease (GERD) GERD is a chronic condition where stomach acid travels into your esophagus and throat, causing irritation and inflammation, a burning chest or stomach pain, nausea, sore throat, and chronic coughing.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cd244ad6-e475-468e-a20c-4b484d142648 Intestinal Dysmotility High blood sugar from diabetes can damage the nerves that coordinate the movements of the intestines, too. This is known as intestinal dysmotility.e60dc2a1-f33c-4a05-9b50-8e3e8e597629295d959a-7058-41ad-b179-631b53508a55
The Takeaway Diabetic gastroparesis is a digestive condition in which food moves too slowly from the stomach to the intestines, causing symptoms like nausea, vomiting, bloating, acid reflux, and abdominal pain. Gastroparesis is a severe complication of diabetes. It develops when the vagus nerve that helps control the digestive system becomes damaged by chronic high blood glucose levels, medications, infections, or abdominal surgery. There is no cure for diabetic gastroparesis, but symptoms can be managed by controlling blood sugar through diet and medications. Those same techniques, including exercise, good sleep, and stress management, can also help prevent the disease.
Resources We Trust Cleveland Clinic: The Gastroparesis DietMayo Clinic: Gastroesophageal Reflux Disease (GERD)National Institute of Diabetes and Digestive and Kidney Diseases: Treatment for GastroparesisJohns Hopkins Medicine: Digestive DisordersAmerican Diabetes Association: Tips for Eating Well
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