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Ask the Doctor
Understanding Gastroparesis

Gastroparesis is a disorder in which the stomach does not empty properly. Normally, most solid food will pass from the stomach within two to four hours after eating. But if you have gastroparesis, food lingers in your stomach and causes bloating, nausea, vomiting, and abdominal pain. Between thirty and fifty percent of those with diabetes have gastroparesis, and it can affect how well your blood sugars are controlled.
Because your food digests so slowly, you may experience problems with either hyperglycemia or hypoglycemia if you take insulin.

Why am I at risk of gastroperesis just because of my diabetes?
High blood sugar levels in diabetes can cause nerve damage over time, and there are nerves embedded in the wall of your gastrointestinal tract. Doctors think damage to these nerves causes gastroparesis.

Is there anything I can do to help prevent getting this condition?
Doctors haven’t proven that controlling your blood sugars alone can prevent gastroparesis. However, keeping your levels below 180 gm/dl may help reduce symptoms because higher blood sugar levels do impair the rate at which your stomach empties.

What are the symptoms of gastroparesis?
You may have nausea, particularly after eating; bloating, which is a sense of fullness that prevents you from eating large meals; vomiting; and abdominal pain. Symptoms may start and stop suddenly or be constant. Gastroparesis may also aggravate heartburn. In mild cases symptoms last just a few days, but in five percent of people with gastroparesis severe symptoms can lead to bouts of dehydration, repeated hospitalizations, and absences from work and family.

How will I know if I have it?
If you have symptoms, your physician will request a radiology test called a solid phase gastric emptying scan. You will eat scrambled eggs prepared with a tracer and then sit with a scanner that will detect the path of the eggs as they move into and out of your stomach over a four-hour period. If you have no other blockage in your stomach or intestine that would interfere with normal stomach emptying, and the food sits in your stomach for a prolonged period, then you have gastroparesis.

What are the best ways to managegastroparesis if I get it?
Avoid foods that have more than three grams of fat per serving, as fat slows stomach emptying. If you have symptoms, avoid fibrous foods like raw vegetables and fruits, because these are harder for your stomach to empty. Instead, switch over to a liquid diet for awhile. Liquids empty from the stomach more rapidly than solid foods. Eat five or six small meals per day. If you are vomiting, drink lots of clear fluids to prevent dehydration. If you cannot keep even liquids down, go to the emergency room so you can get intravenous fluids. Your doctor may prescribe medications to speed stomach emptying, or reduce nausea. Try to keep your blood sugars below 180 gm/dl because higher levels directly slow the emptying of the stomach and can make your symptoms worse. Avoid taking narcotic pain medications as these can further delay your stomach emptying.

What else should I know about diabetes and my digestive system?
If you have gastroparesis you may also have diarrhea or constipation. You should discuss these symptoms with your doctor. If your symptoms are severe enough to interfere with daily activities, consider getting help from a gastroenterologist, a physician who specializes in problems with digestion. To find out more about gastroparesis and current clinical research, visit the National Institutes of Health Gastroparesis
Research Consortium at, or visit the Gastroparesis page at the International Foundation for Functional GI Disorders,

Linda LeeAbout the Author
Linda A. Lee, MD is a gastroenterologist on the faculty of the Johns Hopkins University School of Medicine, specializing in the care of patients with challenging digestive disorders including gastroparesis. Dr. Lee has spent many years conducting cancer-related bench research and caring for oncology patients with digestive symptoms and complications. As a Fellow of the American Gastroenterological Association, she focuses on promoting advances in clinical care and enhancing patient education.