Diabetic Gastroparesis

GENERAL INFORMATION:

What is diabetic gastroparesis? Gastroparesis (gas-troh-pah-REE-sis) 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 also cause the stomach to dilate (stretch) and to not work as fast to digest (break down) food. Gastroparesis happens most often in people who have diabetes. When diabetes leads to this problem, it is called diabetic gastroparesis.

What causes diabetic gastroparesis? With diabetes, your body does not make enough insulin, or the insulin does not work right. Your body needs insulin so that the sugar you get from food can be used for energy. With diabetes, you may have a higher blood sugar than you should. Over a period of time, high blood sugar may cause problems with how your nerves work. A nerve is a pathway that takes messages back and forth between your brain and your body. Gastroparesis may happen because of damage to nerves that control the movement of your stomach and intestines.

What are the signs and symptoms of diabetic gastroparesis? When you have gastroparesis, you may have one or more of the following signs and symptoms:

• Bloating (swelling) and pain in your abdomen (belly). You may burp a lot and have heartburn.
  
  
• Decreased appetite and weight loss.
  
  
• Feeling full when eating even though you may not have eaten much.
  
  
• Nausea (feeling sick to your stomach) and vomiting (throwing up). The food that you vomit may not be digested, even if it has been a while since you ate.

What other problems may diabetic gastroparesis cause? Usually, food moves through your stomach and into your small intestine within a short time. Diabetic gastroparesis delays (slows) the speed at which your food is digested, or broken down into energy. This can make it hard for you to control your blood sugar. If food stays in your stomach too long, you may get an infection. Also, the food can harden into a solid lump called a bezoar (BEE-zor). A bezoar may cause pain, nausea, and blockages in the digestive tract.

How is diabetic gastroparesis diagnosed? At first, you will probably be seen in a clinic or caregiver's office. You may need blood tests, and tests of the organs that make up your digestive tract. Digestive organs that may be tested include your esophagus (food pipe from your mouth to your stomach), stomach, and intestines. There are times you may need to go into the hospital for tests and treatment. Ask your caregiver for more information about any tests you may need.

How is diabetic gastroparesis treated?

• There is no cure for gastroparesis, but the disease can usually be treated with medicines and changes in your diet. Good blood sugar control also helps treat gastroparesis. Some medicines may help increase movement in your digestive tract. These medicines can help your stomach empty more quickly, and help digestion of food. Some medicines may help decrease nausea or hard stools (BM's). Other medicines may help you control your blood sugar. You may need to change the type, the amount, and the timing of your insulin. These changes may help you control your blood sugar better. You may need to make changes in your daily diet and the times you eat. These may include:
  
  
  • Eating foods that are low in fat. Fat slows down the digestion of foods.
    
    
  • Eating foods that are low in fiber. High fiber foods are harder to digest. Avoid foods such as figs, berries, apples, oranges, broccoli, brussels sprouts, and green beans.
    
    
  • Eating several small meals each day, instead of large meals. Small meals may be easier for you to digest.
    
    
  • Eating meals slowly, and completely chewing your food. This may make it easier for your stomach to digest the food.
    
    
  • Eating liquid or blenderized meals until your gastroparesis is controlled. Blenderized meals are made of foods that are thinned in a blender. Liquid or blenderized meals may be easier for you to digest. A nutrition shake (pre-made, or mixed yourself) is an example of a liquid meal. A blenderized meal can be made by mixing solid foods with healthy liquid in a blender. Ask your caregiver for more information about a blenderized diet.
    
    
  • Sit up for at least one hour after eating, instead of lying down, or exercising right away. This may help digestion.
  
  
• If medicines and other treatments do not work, you may need to get your nutrition in other ways. You may need a feeding tube placed in your abdomen. You may also need nutrition given to you through a vein (blood vessel). Ask your caregiver for information about other treatments you may need.

Risks: Without treatment for diabetic gastroparesis, 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. Even with surgery or other treatments, you may need to be fed through a tube into your stomach, intestine, or vein. Your blood sugar may drop too low at times, making it harder to manage your diabetes. Ask your caregiver any questions you have about your diet, medicines, or care.

For information and support:

• It is important to learn as much as you can about diabetes and gastroparesis. You may also want to join a support group. This is a group of people who also have diabetes. Ask your caregiver for the names and numbers of support groups in your area. You can also contact the following organizations for more information:
  • American Diabetes Association
    1701 North Beauregard Street
    Alexandria, VA 22311
    Phone: 1-800-342-2383
    Web Address: http://www.diabetes.org
    
  • National Diabetes Information Clearinghouse
    1 Information Way
    Bethesda, MD 20892-3560
    Phone: 1-800-860-8747
    Web Address: www.diabetes.niddk.nih.gov/
    
  
  
  
• Wear a medical alert bracelet or necklace that says you have diabetes. This can help caregivers treat you in case of an emergency. You may get one from your local drugstore or contact the MedicAlert Foundation listed below:
  • MedicAlert Foundation
    2323 Colorado Avenue
    Turlock, CA 95382
    Phone: 1-888-633-4298
    Web Address: http://www.medicalert.org
    

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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