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 www.gpcrc.us, or visit the Gastroparesis page at the
International Foundation for Functional GI Disorders, www.aboutgiMotility.org
About
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.