Diabetic Gastroparesis

WHAT YOU SHOULD KNOW:

Gastroparesis is a lack of movement in the stomach. This decreased movement of the stomach causes food to leave the stomach more slowly. Gastroparesis is also called delayed gastric emptying. Gastroparesis may cause the stomach to dilate (stretch) and not work as fast to digest food. Gastroparesis happens most often in people who have diabetes. When diabetes leads to this problem, it is called diabetic gastroparesis.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Diabetic gastroparesis makes it hard for you to control your blood sugar. If food stays in your stomach too long, you may get an infection. The food can harden into a solid lump called a bezoar. A bezoar may cause pain and nausea, and it may block your digestive tract.
  
  
• Without treatment, you may have long-term nausea and vomiting. You may not get enough nutrients from your food, and you may lose weight. You may need procedures or surgery if gastroparesis gets worse. You may need to be fed through a tube into your stomach, intestine, or vein. Your blood sugar may go too high or low without any pattern, making it harder to manage your diabetes. Ask your caregiver any questions you have about diabetic gastroparesis and these risks.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Monitoring:

You may need one or more of the following:

• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Weight: You may be weighed each day. Caregivers compare your weight from day to day. This helps caregivers make sure you are not gaining or losing weight too fast.

Tests:

You may need one or more of the following tests. The results of these tests help caregivers plan the best way to treat you.

• Radioisotope gastric-emptying scan: A special x-ray machine uses a special camera to take pictures of your stomach. You are given food to eat that has a small, safe amount of radioactive material in it before taking the pictures. Caregivers then watch the pictures to see how quickly the food leaves your stomach. People who are allergic to shellfish (crab, lobster, or shrimp) may be allergic to the material. Tell your caregiver if you are allergic to any of these foods.
  
  
• Abdominal x-rays: Abdominal x-rays are pictures of the organs inside your abdomen. Caregivers use these pictures to look for problems such as blocked or ruptured intestines, kidney stones, or solid masses (tumors) in your organs.
  
  
• Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.
  
  
• Barium meal: Caregivers will have you eat a meal that has barium in it. Barium is a liquid that helps your stomach and intestines show up better in x-rays. A x-ray machine is then used to take pictures of your stomach. Caregivers watch the pictures to see how your stomach digests the meal.
  
  
• Barium swallow: This test is an x-ray of your throat and esophagus, the tube connecting your throat to your stomach. This test may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. Follow the instructions of your caregiver before and after the test.
  
  
• Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.
  
  
• Gastric manometry: Gastric manometry test helps caregivers see if there are problems with how your stomach is working. A small, flexible tube is passed down your throat into your stomach. Pressure readings are taken that may tell your caregiver if there are problems with swallowing or digestion.
  
  
• Upper GI x-rays: During an upper GI series, an x-ray machine is used to take pictures of your stomach and intestines (bowel). You may be given a chalky liquid to drink before the pictures are taken. This liquid helps your stomach and intestines show up better on the x-rays. An upper GI series can show if you have an ulcer, a blocked intestine, or other problems.

Treatment options:

Your treatment may change if your health problem is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.

• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Central line: This is a special IV catheter or tube. It is put into a large vein (blood vessel) near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. Other central lines, such as a PICC, may be put into your arm. You may need a central line to receive medicines or IV fluids that need to be given through a big vein. You may need a central line if it is hard for caregivers to insert a regular IV. Also, a central line may stay in longer than a regular IV can. Some central lines may also be used to take blood samples.
  
  
• TPN: TPN stands for total parenteral nutrition. It is also called hyperalimentation. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is used when you have problems with eating or digesting food. TPN is usually put into your body through a large IV catheter, such as a central line. You may need TPN for several days or longer.
  
  
• Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.
  
  
• Jejunostomy tube (J-Tube): A jejunostomy tube is a small, flexible tube that is put into a small cut in your abdomen. The end of the tube goes into your small intestine (bowel). The tube is used to give you liquids, food, and medicine. You may have a J-tube for a short time, or long-term. If you need it long-term, your tube may need to be replaced with a new one at certain times.
  
  
• Gastric pacing: Caregivers may do surgery to place a special device into a part of your stomach. The machine will send messages to your stomach to help your stomach empty.

Medicines:

• Insulin: This medicine may be given to decrease the amount of sugar in your blood. It helps your body move the sugar to your cells, where it is needed for energy.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Motility medicine: This medicine is given to help your stomach muscles move food and liquids out of your stomach faster. This medicine also may help you digest food better.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Diabetic Gastroparesis (Inpatient Care)