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Diabetic Gastroparesis

Gastroparesis, or delayed gastric emptying, is when food moves through the stomach more slowly than normal. In someone with diabetes, it’s caused by damage to the vagus nerve because of chronic high blood sugar. (Other chronic diseases may also cause gastroparesis.) The vagus nerve helps control how food moves through the digestive system. When this nerve is damaged, the movement of food is slowed down or stopped.

Food that stays in the stomach for too long can cause problems. Food can ferment in the stomach, causing bacteria to grow. Undigested food can also harden into masses called bezoars. These can cause nausea and vomiting. In some cases, they may block food from passing from the stomach to the small intestine.

Gastroparesis can make it hard to manage blood sugar levels because it is hard to predict when a meal will actually leave the stomach to be digested. It can also cause problems with vitamins and minerals being absorbed into the body as well as maintaining a healthy weight.

Symptoms of diabetic gastroparesis are:

  • Nausea

  • Vomiting

  • Feeling full after eating a small amount of food

  • Stomach pain or cramps

  • Heartburn

  • Stomach bloating

  • Weight loss

  • Loss of appetite

  • High or low blood sugar levels

There are several different tests and studies that can help diagnose gastroparesis.

For many people, gastroparesis is a lifelong health problem. Managing it will likely include changes in how you eat. You may be prescribed medicine to help with blood sugar levels, help your symptoms like nausea and vomiting, or act on muscles in the digestive system. Certain medicines otherwise very effective for diabetes can make gastroparesis worse and should not be taken. In severe cases, surgery to put in a feeding tube may be needed. Or a special device may be implanted to encourage the stomach muscles to contract.

Home care

These changes may help ease your symptoms:

  • Take prescribed medicines exactly as directed.

  • Eat a liquid or soft diet if advised.

  • Eat frequent small meals instead of less frequent large meals.

  • Stay away from foods that are high in fat (such as whole milk, cheese, and fried foods) or fiber (such as beans, and many fruits and vegetables). These can slow digestion.

  • Always control your blood sugar levels as well as possible as directed by your healthcare provider.

Follow-up care

Follow up with your healthcare provider as advised. Regular visits may be needed to manage gastroparesis.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Severe pain in your abdomen

  • Inability to keep down food or liquids

  • Weight loss

  • Other symptoms as directed by your healthcare provider

Online Medical Reviewer: Hanrahan, John, MD
Online Medical Reviewer: Hurd, Robert, MD
Date Last Reviewed: 6/1/2018
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