If you have diabetes and you are having ongoing problems with digestion, your stomach woes could be a sign of gastroparesis. Gastroparesis, also called “delayed gastric emptying,” affects some people with type 1 or type 2 diabetes. So how can you tell if your stomach discomfort might be gastroparesis? Read further for answers to key questions.
What causes it?
Gastroparesis occurs over time when high blood sugar levels damage the vagus nerve. The vagus nerve controls the movement of food through the digestive tract. When it is damaged, the stomach takes longer to empty, resulting in uncomfortable symptoms.
What are the symptoms of gastroparesis?
- Vomiting of undigested food
- Acid reflux or acid regurgitation
- Feeling full when you haven’t eaten much
- Abdominal bloating
- Poor appetite
- Weight loss
- Stomach spasms
- Erratic blood glucose levels
How often symptoms occur and whether they are mild or severe varies for each person.
How is it diagnosed?
Gastroparesis can be difficult to diagnose because the symptoms are similar to those of other health conditions. Doctors try to rule out other conditions first. Your doctor will probably ask questions about your symptoms and medical history and do a physical exam and blood tests. Based on this information, your doctor may recommend gastric emptying tests, such as gastric emptying scintigraphy or barium x-ray. Other tests may be recommended to check if something else may be causing the problem. These tests include upper endoscopy, upper GI series, or ultrasound.
How is it treated?
Treatment for gastroparesis related to diabetes involves getting blood sugar levels under control and improving gastric emptying. Some medicines may also be prescribed to treat gastroparesis.
- Controlling blood sugar
To keep blood sugar levels under control, people with diabetes and gastroparesis may need to change their regimen for insulin or oral diabetes medicines, change the type of insulin they use, and check blood sugar levels more frequently.
- Improving gastric emptying
Dietary changes can help improve gastric emptying. Eating smaller, more frequent meals, avoiding high-fat and fibrous foods, or switching to several liquid or pureed meals a day may help initially. Sometimes doctors recommend seeing a dietitian.
- Taking medications
The only FDA-approved medicine to treat gastroparesis is metoclopramide (Reglan®), which helps improve gastric emptying and nausea and vomiting. Other prescription medicines may include antibiotics (erythromycin), medicines to treat nausea and vomiting (ondansetron) or, in some cases, a nerve-blocking agent (botulinum toxin).
What are the complications of gastroparesis?
Problems that may occur if gastroparesis is left untreated include:
- Dehydration (from chronic vomiting)
- Electrolyte imbalances
- Gastroesophageal reflux disease (GERD)
- A solid mass of undigested material that accumulates in the digestive tract (called a bezoar), which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications
- Blood sugar levels that are out of control
- Malnutrition (from poor nutrient absorption or too few calories)
- Decreased quality of life, including work absences due to severe symptoms
If you think you might have gastroparesis, talk to your doctor about your symptoms.
Complications from Diabetes, Centers for Disease Control
Gastroparesis, American Diabetes Association
Gastroparesis, National Institute of Diabetes and Digestive and Kidney Diseases
Gastroparesis, National Institutes of Health