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Diabetic Gastroparesis

Curated by Claudia Shannon / Research Scientist / ishonest

Symptoms of gastroparesis

The following are symptoms of gastroparesis:

  • heartburn
  • nausea
  • vomiting of undigested food
  • early fullness after a small meal
  • weight loss
  • bloating
  • loss of appetite
  • blood glucose levels that are hard to stabilize
  • stomach spasms
  • acid reflux

Gastroparesis symptoms may be minor or severe, depending on the damage to the vagus nerve, a long cranial nerve that extends from the brainstem to the abdominal organs, including those of the digestive tract.

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Symptoms can flare up any time, but are more common after the consumption of high-fiber or high-fat foods, all of which are slow to digest.

Risk factors for gastroparesis

Women with diabetes have a high risk for developing gastroparesis. Other conditions can compound your risk of developing the disorder, including previous abdominal surgeries or a history of eating disorders.

Diseases and conditions other than diabetes can cause gastroparesis, like:

  • viral infections
  • acid reflux disease
  • smooth muscle disorders

Other illnesses can cause gastroparesis symptoms, including:

  • Parkinson’s disease
  • chronic pancreatitis
  • cystic fibrosis
  • kidney disease
  • Turner syndrome
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Sometimes no known cause can be found, even after extensive testing.

Causes of gastroparesis

People who have gastroparesis have damage to their vagus nerve. This impairs nerve function and digestion because the impulses needed to churn food are slowed or stopped. Gastroparesis is difficult to diagnose and thus often goes undiagnosed.

Gastroparesis is more common in people who have high, uncontrolled blood glucose levels over a long period of time. Extended periods of high glucose in the blood cause nerve damage throughout the body.

Chronically high blood sugar levels also damage the blood vessels that supply the body’s nerves and organs with nutrition and oxygen. This includes the vagus nerve and digestive tract, both of which ultimately lead to gastroparesis.

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Because gastroparesis is a progressive disease, and some of its symptoms like chronic heartburn or nausea seem common, you may not realize that you have the disorder.

Complications of gastroparesis

When food isn’t digested normally, it can remain inside the stomach, causing symptoms of fullness and bloating. Undigested food can also form solid masses called bezoars that can contribute to:

  • nausea
  • vomiting
  • obstruction of the small intestines

Gastroparesis presents significant problems for people with diabetes because delays in digestion make controlling blood glucose difficult.

The disease makes the digestion process hard to track, so glucose readings can fluctuate. If you have erratic glucose readings, share them with your doctor, along with any other symptoms you’re experiencing.

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Gastroparesis is a chronic condition, and having the disorder can feel overwhelming.

Going through the process of making dietary changes and trying to control blood sugar levels while feeling sick and nauseated to the point of vomiting is exhausting. Those with gastroparesis often feel frustrated and depressed.

Diagnosis

Your doctor will consider a variety of factors before diagnosing you with diabetic gastroparesis. They’ll consider your medical history and symptoms, and perform a physical exam to check for signs of gastroparesis. Signs could include:

  • abdomen tenderness or pain
  • dehydration
  • malnutrition

Your doctor may also order blood or urine tests to check for any complications of gastroparesis. Imaging tests may also be used to check for any abdominal obstructions.

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Some other tests your doctor may perform include esophagogastroduodenoscopy or gastric emptying scintigraphy.

An esophagogastroduodenoscopy can rule out infections and detect the presence of any food left in the stomach. Gastric emptying scintigraphy is a tool used for assessing gastric emptying. It’s considered the gold standard in the diagnosis of gastroparesis.

Treatment of gastroparesis

Your doctor will also likely adjust your insulin regimen as needed. They may recommend the following:

  • taking insulin more often or changing the type of insulin you take
  • taking insulin after meals, instead of before
  • checking blood glucose levels frequently after eating and taking insulin when necessary

Your doctor will be able to give you more specific instructions on how and when to take your insulin.

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Gastric electrical stimulation is a possible treatment for severe cases of gastroparesis. In this procedure, a device is surgically implanted into your abdomen. It delivers electrical pulses to the nerves and smooth muscles of the lower part of your stomach. This may reduce nausea and vomiting.

In severe cases, long-term gastroparesis sufferers may use feeding tubes and liquid food for nutrition.

Diet tips for gastroparesis prevention

People with gastroparesis should avoid eating high-fiber, high-fat foods, as they take longer to digest. These include:

  • raw foods
  • higher-fiber fruits and vegetables like broccoli
  • rich dairy products, like whole milk and ice cream
  • carbonated beverages

Doctors also recommend eating smaller meals throughout the day, and blended foods if needed. It’s important to keep yourself properly hydrated as well, especially if you have vomiting.

Takeaway

There’s no cure for gastroparesis — it’s a chronic condition. But it can be successfully managed with dietary changes, medications, and proper control of blood glucose. You’ll have to make some changes, but you can continue to lead a healthy and fulfilling life.

Read this article in Spanish.

Read more on: diabetes


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