Gastroparesis is a disorder in which the stomach takes too
long to empty its contents. It is most often a complication of
type 1 diabetics. At least 20 % of people with Type1 diabetes
develop gastroparesis. It also occurs in people with type 2
diabetes, although less often.
Gastroparesis happens when nerves to the stomach are
damaged or stop working. The vagus nerve controls the
movement of food through the stomach and the digestive
tract. If the vagus nerve is damaged, the muscles of the
stomach and intestines do not work normally, and the
movement of the food is slowed or stopped.
Diabetes can damage the Vagus nerve if BG levels remain
high over a long period of time. High BG causes chemical
changes in nerves and damages the blood vessels that carry
oxygen and nutrients to the nerves.
The symptoms of gastroparesis are nausea, and vomiting,
an early feeling of fullness when eating, Weight loss,
abdominal bloating, Abdominal discomfort. These symptoms
could be mild or severe (depending on the person).
If the food lingers too long in the stomach it can cause
problems like bacterial over-growth from the fermentation of
food. Also, the food can harden into solid masses called
bezoars that may cause nausea, vomiting, and obstruction in
the stomach. Bezoars can be dangerous if they block the
passage of food into the small intestine.
Gastroparesis can make diabetes worse by adding to the
difficulty of controlling BG. When food that has been delayed
in the stomach finally enters the small intestine and is
absorbed, BG levels rise. Since gastroparesis makes
stomach emptying unpredictable, a person's BG levels can
be erratic and difficult to control.
There are several tests that may be done to see if you have
gastroparesis.
Barium X-ray is one, after fasting for 12 hours; you will drink
the barium, (yuck) which will coat the inside of the stomach.
Normally the stomach will be empty of all food after 12 hours
of fasting, if the X-ray shows any food in the stomach,
gastroparesis is likely. Even if you stomach shows empty you
still could have gastroparesis, it all depends on your
stomach, some times it dumps correctly. If your Doctor
suspects that you do indeed have gastroparesis, he will want
to repeat the test on another day.
Now here is the fun test I had, they put a radioactive
substance in a scrambled egg and had me eat it, I had fasted
for 12 hours, could not even take my morning meds, after
eating the egg. (YUM!) I lay on a table for 2 hours while a
machine scanned me. It watched to see how quickly the food
left my stomach. Gastroparesis is diagnosed if more than half
of the food remains in the stomach after 2 hours. Now a
normal persons stomach will empty in 90 minutes. They did
the math, and it takes my stomach 200 minutes to empty.
Can't say I am normal!
The doctor may order lab test to check blood counts and to
measure chemical and electrolyte levels.
There is a test called Barium beefsteak meal, this one they
put the barium in the meal and the radiologist watches your
stomach as it digests the meal. (Thought I had some nasty
jobs). The amount of time it takes for the barium meal to be
digested and leave the stomach gives the doctor an idea of
how well the stomach is working. This test works much
better than the barium one, because you usually empty
liquids much faster than solids.
Doctors can also do an endoscopy to look around your
stomach. I personally like that one! You get knocked out and
get some nice sleepy time drugs and get to sleep the rest of
the day, and don't have to cook and make any big decisions.
But I am just easy. Then they most often will do an
ultrasound to rule out the gallbladder or pancreatitis as a
source of the problem.
Unfortunately there really is not cure for this. You have to
change your diet, stay away from fatty foods, and a lot of
high fiber meals, just do the best you can do with it. It is just
a guessing game, you need to figure out what you can and
can't eat, and what makes you sicker than something else.
Sometimes even liquids can make you ill. There are
medications you can take for it that do some good, one is
called Reglan. This one is usually taken 3 times a day
(around meal time). There are many nausea pills around,
and over the counter motion sickness pills help some too.
Your medication for acid reflux like Nexium, Propulsid,
Prilsec, do give you some relief. He may also want to do
some changes to your insulin, as to when you take it and
how much, or change the insulin all together.
Your Doctor may also recommend that you eat 6 small meals
a day rather than 3 larger meals a day, and if you are very
nauseated that the meals be liquid meals for a while, so your
stomach can empty and have a chance to get rested and
healed and get back to normal some what. But do remember
if you are on liquids that the liquid meals should provide all
the nutrients found in solid food, and it can pass through the
stomach more easily and quickly.
I am not the diabetic in the family, but am sticking to the
same diet as Mike (who is the diabetic), but when I just
cannot eat food I drink Ensure for my meals. It does have 35
to 40 carbs in it, but if that is all you are going to have, you
are going to need them. You are going to need to watch you
BG's and keep up with your insulin thru all of this. You have
to watch you BG's closely, and make sure you are eating
something.
If this gets to bad, they can put in feeding tubes called a
jejunostomy. It is inserted through the skin on your abdomen
into the small intestine. The feeding tube allows you to put
nutrients directly into the small intestine and bypassing the
stomach altogether. You will receive special liquid food to
use with the tube. By doing it this way you are putting the
nutrients and medications directly into the small intestine,
you will ensure that these products are digested and
delivered to your bloodstream quickly. This tube can be
temporary and is used only if necessary when gastroparesis
is severe.
So to sum this all up, gastroparesis is a common
complication of type1 diabetes
It is the result of damage to the vagus nerve, which controls
the movement of food through the digestive system.
The vagus nerve becomes damaged after years of poor BG
control.
Symptoms are nausea, vomiting, and early fullness, weight
loss.
It is diagnosed through tests such as X-rays and scanning.
Treatments include changes in when and what you eat,
changes in insulin type and times of injections oral meds, or
a jejunostomy.
long to empty its contents. It is most often a complication of
type 1 diabetics. At least 20 % of people with Type1 diabetes
develop gastroparesis. It also occurs in people with type 2
diabetes, although less often.
Gastroparesis happens when nerves to the stomach are
damaged or stop working. The vagus nerve controls the
movement of food through the stomach and the digestive
tract. If the vagus nerve is damaged, the muscles of the
stomach and intestines do not work normally, and the
movement of the food is slowed or stopped.
Diabetes can damage the Vagus nerve if BG levels remain
high over a long period of time. High BG causes chemical
changes in nerves and damages the blood vessels that carry
oxygen and nutrients to the nerves.
The symptoms of gastroparesis are nausea, and vomiting,
an early feeling of fullness when eating, Weight loss,
abdominal bloating, Abdominal discomfort. These symptoms
could be mild or severe (depending on the person).
If the food lingers too long in the stomach it can cause
problems like bacterial over-growth from the fermentation of
food. Also, the food can harden into solid masses called
bezoars that may cause nausea, vomiting, and obstruction in
the stomach. Bezoars can be dangerous if they block the
passage of food into the small intestine.
Gastroparesis can make diabetes worse by adding to the
difficulty of controlling BG. When food that has been delayed
in the stomach finally enters the small intestine and is
absorbed, BG levels rise. Since gastroparesis makes
stomach emptying unpredictable, a person's BG levels can
be erratic and difficult to control.
There are several tests that may be done to see if you have
gastroparesis.
Barium X-ray is one, after fasting for 12 hours; you will drink
the barium, (yuck) which will coat the inside of the stomach.
Normally the stomach will be empty of all food after 12 hours
of fasting, if the X-ray shows any food in the stomach,
gastroparesis is likely. Even if you stomach shows empty you
still could have gastroparesis, it all depends on your
stomach, some times it dumps correctly. If your Doctor
suspects that you do indeed have gastroparesis, he will want
to repeat the test on another day.
Now here is the fun test I had, they put a radioactive
substance in a scrambled egg and had me eat it, I had fasted
for 12 hours, could not even take my morning meds, after
eating the egg. (YUM!) I lay on a table for 2 hours while a
machine scanned me. It watched to see how quickly the food
left my stomach. Gastroparesis is diagnosed if more than half
of the food remains in the stomach after 2 hours. Now a
normal persons stomach will empty in 90 minutes. They did
the math, and it takes my stomach 200 minutes to empty.
Can't say I am normal!
The doctor may order lab test to check blood counts and to
measure chemical and electrolyte levels.
There is a test called Barium beefsteak meal, this one they
put the barium in the meal and the radiologist watches your
stomach as it digests the meal. (Thought I had some nasty
jobs). The amount of time it takes for the barium meal to be
digested and leave the stomach gives the doctor an idea of
how well the stomach is working. This test works much
better than the barium one, because you usually empty
liquids much faster than solids.
Doctors can also do an endoscopy to look around your
stomach. I personally like that one! You get knocked out and
get some nice sleepy time drugs and get to sleep the rest of
the day, and don't have to cook and make any big decisions.
But I am just easy. Then they most often will do an
ultrasound to rule out the gallbladder or pancreatitis as a
source of the problem.
Unfortunately there really is not cure for this. You have to
change your diet, stay away from fatty foods, and a lot of
high fiber meals, just do the best you can do with it. It is just
a guessing game, you need to figure out what you can and
can't eat, and what makes you sicker than something else.
Sometimes even liquids can make you ill. There are
medications you can take for it that do some good, one is
called Reglan. This one is usually taken 3 times a day
(around meal time). There are many nausea pills around,
and over the counter motion sickness pills help some too.
Your medication for acid reflux like Nexium, Propulsid,
Prilsec, do give you some relief. He may also want to do
some changes to your insulin, as to when you take it and
how much, or change the insulin all together.
Your Doctor may also recommend that you eat 6 small meals
a day rather than 3 larger meals a day, and if you are very
nauseated that the meals be liquid meals for a while, so your
stomach can empty and have a chance to get rested and
healed and get back to normal some what. But do remember
if you are on liquids that the liquid meals should provide all
the nutrients found in solid food, and it can pass through the
stomach more easily and quickly.
I am not the diabetic in the family, but am sticking to the
same diet as Mike (who is the diabetic), but when I just
cannot eat food I drink Ensure for my meals. It does have 35
to 40 carbs in it, but if that is all you are going to have, you
are going to need them. You are going to need to watch you
BG's and keep up with your insulin thru all of this. You have
to watch you BG's closely, and make sure you are eating
something.
If this gets to bad, they can put in feeding tubes called a
jejunostomy. It is inserted through the skin on your abdomen
into the small intestine. The feeding tube allows you to put
nutrients directly into the small intestine and bypassing the
stomach altogether. You will receive special liquid food to
use with the tube. By doing it this way you are putting the
nutrients and medications directly into the small intestine,
you will ensure that these products are digested and
delivered to your bloodstream quickly. This tube can be
temporary and is used only if necessary when gastroparesis
is severe.
So to sum this all up, gastroparesis is a common
complication of type1 diabetes
It is the result of damage to the vagus nerve, which controls
the movement of food through the digestive system.
The vagus nerve becomes damaged after years of poor BG
control.
Symptoms are nausea, vomiting, and early fullness, weight
loss.
It is diagnosed through tests such as X-rays and scanning.
Treatments include changes in when and what you eat,
changes in insulin type and times of injections oral meds, or
a jejunostomy.
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By: Nancy Brown
15th Edition October 200
6