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Gastroparesis

Diabetes and the Development of Gastroparesis

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Updated November 29, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Gastroparesis

The stomach (red) naturally empties into the intestine unless gastroparesis slows the process.

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Gastroparesis is a disorder that affects both those with type 1 and type 2 diabetes. It is a condition where your stomach takes too long to empty its contents. Gastroparesis is a type of neuropathy, or nerve damage, that affects the vagus nerve.

The vagus nerve has several functions. It helps to regulate your heartbeat, control muscle movement, and maintain steady breathing. It is also responsible for moving the food through your digestive tract. If the vagus nerve becomes damaged or stops working, the muscles in the stomach and intestines do not work properly, and the movement of food through the stomach is delayed or slowed.

What Causes Gastroparesis?

The main culprit in the development of gastroparesis is high blood sugar. Over time, high glucose levels can damage the vagus nerve by restricting oxygen and blood flow to this nerve. There are other causes of gastroparesis, such as viral infections, hypothyroidism, and medications, but diabetes is the most common cause.

What are the Symptoms of Gastroparesis?

Depending on the person and stage of development, the following symptoms may be mild or severe. Some of the most common symptoms are:

  • Nausea
  • Vomiting of undigested food
  • Heartburn
  • Weight loss
  • Abdominal bloating
  • Lack of appetite
  • Early sensation of fullness when eating
  • Spasms of the stomach wall

What Problems are Associated with Gastroparesis?

The typical pathway is for food to enter your stomach, move to your intestine, and then be absorbed by your body. This all happens within a relatively short amount of time. But gastroparesis causes a delay in moving the food from the stomach to the intestine. Gastroparesis makes it more difficult to manage your blood sugar because the delay in the stomach's ability to move and empty the food you've eaten causes your blood sugar to rise.

In addition to higher blood glucose, the delayed emptying of the stomach can also harden into solid masses that can cause other problems, such as nausea, vomiting, and even obstruction of the passage of food from the stomach to the intestine, which can be a dangerous situation if not quickly diagnosed and corrected.

How is Gastroparesis Diagnosed?

There are several tests that can be used to diagnose gastroparesis. One requires the person to drink a barium solution after a 12-hour fast. The barium covers the inside of the stomach, and with the use of scan technology, can determine if the emptying of food from the stomach into the intestine is being delayed.

Another diagnostic test involves eating food that contains a slightly radioactive but safe material. A scan that can detect the radioactive material is used to determine how quickly food is eliminated from the stomach.

In addition to scan technology, the electrical and muscular activity of the stomach can be tested to determine how effectively the stomach is working to move food into the intestine.

How is Gastroparesis Treated?

For people with diabetes, the most important treatment consideration is managing your blood glucose. As with many of the health complications that can result from diabetes, gastroparesis can improve with good management of blood sugar levels.

Your doctor may recommended one or more of the following treatments:

  • Because food is being absorbed more slowly, you may need to take more insulin or alter your schedule of insulin based upon your doctor's recommendations.
  • Eating smaller and more frequent meals throughout the day can keep the stomach from becoming overly full.
  • Avoiding high-fat and high-fiber foods may help. Fat takes longer to digest and fiber is difficult to digest.
  • Medications may be used to ease the symptom of gastroparesis.

If these treatments don’t work, you may need surgery to insert a feeding tube. The tube is inserted through the skin into the small intestine and allows you to bypass the stomach altogether to get the nutrients you need.

Source:

American Diabetes Association. "Gastroparesis.”

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