By Adam Garcia
We will be discussing the term gastroparesis in Diabetic Dictionary today. We will also discuss the common causes and symptoms, other complications, and some of the types of treatment that are available for gastroparesis.
Gastroparesis (gas-tro-puh-REE-sis) is a form of neuropathy that affects the stomach. Digestion of food may be incomplete or delayed. This may make blood glucose control very difficult. Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.
Now, the most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve. Some other causes of gastroparesis are surgery on the stomach or vagus nerve; viral infections; anorexia nervosa or bulimia; medications, such as anticholinergics and narcotics, that slow contractions in the intestine; gastroesophageal reflux disease; smooth muscle disorders, such as amyloidosis and scleroderma; nervous system diseases, including abdominal migraine and Parkinson’s disease; and metabolic disorders, including hypothyroidism. Many people have what is called idiopathic gastroparesis, meaning the cause is unknown and cannot be found even after medical tests.
Some of the common signs and symptoms of gastroparesis are heartburn, pain in the upper abdomen, nausea, vomiting of undigested food, early feeling of fullness after only a few bites of food, weight loss due to poor absorption of nutrients or low calorie intake, abdominal bloating, high and low blood glucose levels, lack of appetite, gastroesophageal reflux, and spasms in the stomach area. Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms. The symptoms of gastroparesis may be mild to severe, depending on the person. Symptoms can happen frequently in some people and less often in others. Many people with gastroparesis experience a wide range of symptoms, and sometimes the disorder is difficult for the physician to diagnose.
There are other complications of gastroparesis. For example, if food lingers too long in the stomach, it can cause bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine. Gastroparesis can make diabetes worse by making blood glucose control more difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person’s blood glucose levels can be erratic and difficult to control.
The primary treatment goals for gastroparesis related to diabetes are to improve stomach emptying and regain control of blood glucose levels. Treatment includes dietary changes, insulin, oral medications, and, in severe cases, a feeding tube and parenteral nutrition. For dietary changes, the doctor might suggest consuming six smaller meals to help restore your blood glucose to more normal levels before testing you for gastroparesis. In some cases, the doctor or dietitian may recommend you try eating several liquid or pureed meals a day until your blood glucose levels are stable and the symptoms improve. Liquid meals provide all the nutrients found in solid foods, but can pass through the stomach more easily and quickly. If you have gastroparesis, food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to take insulin more often or change the type of insulin you take, take your insulin after you eat instead of before, or check your blood glucose levels frequently after you eat and administer insulin whenever necessary. Your doctor will give you specific instructions for taking insulin based on your particular needs.
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