gastroparesis

Gastroparesis is a condition where the stomach takes to long to empty. It often occurs in people with type 1 diabetes or type 2 diabetes.

Is Gastroparesis fatal?

Gastroparesis usually is not fatal. However, in severe conditions, the stomach muscles can’t function at all which prevents the stomach from emptying and digesting food properly. This can cause malnutrition, the development of hardened food material in the stomach (which is potentially fatal), and dehydration.

Diabetic Gastroparesis

In individuals with diabetes, gastroparesis is usually caused by damaged nerves. In individuals who don’t have diabetes, the nerve functions well but the muscles do not respond.

How does Gastroparesis affect Diabetics?

Gastroparesis can make it difficult for people with diabetes to control their blood sugar levels. This occurs because if the stomach empties too slowly, it can have the same effects on blood sugar as skipping a meal. Blood sugars will plummet and rise depending on when the stomach empties.

Symptoms?

The most common symptoms are:

  • nausea
  • vomiting of undigested food
  • full stomach when you eat a small amount of food
  • weight loss with normal eating
  • abdominal bloating
  • heart burn
  • gastroesophageal reflux
  • spasms of the stomach wall

Causes?

Gastroparesis is caused by damage to or dysfunction of peripheral nerves and muscles, mainly the vagus nerve. The vagus nerve is responsible for mediating many automatic functions of the body, including heart rate and digestion. If the vagus nerve is not working properly, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Gastroparesis is typically not caused by stress.

What happens during gastroparesis?

When a person has gastroparesis, the stomach is able to receive food from the esophagus but it is unable to release the food to the small intestine. When this happens, the stomach acid can travel up the esophagus causing a burning sensation in the middle of the chest (heartburn).

As a result of having gastroparesis, the stomach may feel full after small meals. This occurs because the stomach may not have emptied its contents from previous meal(s). In extreme cases, several meals will accumulate in the stomach and cause severe bloating.

How is gastroparesis diagnosed?

Your doctor can diagnose gastroparesis by performing the following tests:

  • Gastric emptying study
    • This test is very important. Your doctor will haveyou eat a very light meal that contains a small amount of radioactive material. After eating the meal, the radioactive material will be monitored to see how long it takes for the food to leave your stomach.
    • Before you take this test, talk to your doctor about your current medications. You might need to temporarily stop taking the medication if it interferes with digestion.
  • Upper GI endoscopy
    • This test will provide a picture of your upper digestive system. The picture will be used to examine your esophagus, stomach, and beginning of the small intestine.
    • To perform this test, a tiny camera will be inserted into your esophagus. This test is very valuable because it provides a detailed picture of parts of your digestive track and can uncover stomach ulcers.
  • Ultrasound
    • An ultrasound involves taking picture of the insides of your body. Ultrasounds are used to determine if other undiagnosed problems are causing gastroparesis.
  • Upper GI series
    • This test involves drinking a white liquid (barium) that coats the digestive system to help uncover abnormalities.

Treatment options for gastroparesis?

Gastroparesis can be treated. The most common treatments for gastroparesis are:

  • medications
    • Medication to stimulate the stomach muscles. The most common prescribed medicines are:
      • Metoclopramide (Reglan) has serious side effects
      • Erythromycin (Eryc, E.E.S.) loses effectiveness over time an can cause diarrhea.
    • Medications to control nausea and vomiting. The most common prescribed medicines are
      • Prochlorperazine (Compro)
      • Diphenhydramine (Benadryl, Unisom).
      • Ondansetron (Zofran).
  • special exercises during and after meals
  • special massages during and after meals
  • modification of meal plan
    • Your doctor might suggest
      • Eating several smaller meals each day
      • Chewing food thoroughly until there is almost nothing left in your mouth. This makes digestion very easy for your stomach and allows your body to more easily absorb the food’s nutrition.
      • Eating well-cooked fruits and vegetables rather than raw fruits and vegetable.
      • Adding more soups and pureed foods to your diet.

Questions to ask your doctor

  • How can I lessen the pain of gastroparesis?
  • What caused it?
  • Do I need to change how often I eat meals and snacks?
  • What types of foods should I avoid?
  • How long will I have it?
  • What are my treatment options?
    • Will the treatment options interfere with my current medications?
    • How long do I need to take medicine?
    • Is there a medical trial that I can join?
    • Do I need surgery?
  • How do I know if the gastroparesis is getting better/worse?
  • What symptoms can’t be ignored and require immediate medical attention?
  • What is my longterm outlook?