Gastroparesis is delayed gastric (stomach) emptying without anything blocking the way. It occurs when food moves through the stomach more slowly than normal. Most people with diabetes tend to have this condition. It could be caused by damage to the vagus nerve because of chronic high blood sugar. The vagus nerve helps control how food moves through the digestive system. When this nerve is damaged, the movement of food slows down or stops. Other long-term (chronic) conditions may also cause gastroparesis.
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 (glucose) levels because carbohydrate absorption (the body's process of taking in carbohydrates) depends on how fast the stomach empties. Slower emptying results in a higher level of carbohydrate absorption. This leads to a spike in blood sugar levels that is not normal. With this condition, it's hard to predict when a meal will leave the stomach to be digested and used by the body. So it becomes difficult to maintain a steady blood sugar level. 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 (most common).
-
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.
-
Nutritional deficiencies.
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, to help with symptoms like nausea and vomiting, or to act on muscles in the digestive system. Certain medicines that are otherwise 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 in the abdomen to encourage the stomach muscles to contract. This is called gastric electrical stimulation.
Home care
These lifestyle changes, and following a gastroparesis diet, 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.
-
Eat nutritious foods first. Check with your health care provider about starting nutritional or dietary supplements. If you have a deficiency, you may need to take iron, vitamin D, and calcium.
-
Avoid caffeine, alcohol, and tobacco products. They can make the symptoms worse.
-
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.
-
Find out which high-fiber foods make your nausea or vomiting worse and avoid them.
-
Avoid carbonated or fizzy drinks. They can cause bloating and gastric distention.
-
Avoid foods that may cause bezoar, such as fruits with peelings, berries, coconut, legumes, and fiber supplements.
-
Do not lie down immediately after eating. Sit or walk for 1 to 2 hours after meals or as advised by your provider.
-
Always control your blood sugar levels as well as possible as directed by your provider.
-
Talk to a registered dietitian nutritionist (RDN). They can help you create an individualized meal plan based on your specific needs, nutritional requirements, and the timing of your meals.
-
See your dental care team regularly to take care of your mouth, teeth, and gums.
Follow-up care
Follow up with your health care provider as advised. Regular visits may be needed to manage gastroparesis.
When to get medical advice
Contact your health care provider right away if you have:
-
Severe pain in your belly (abdomen).
-
Inability to keep down food or liquids.
-
Weight loss.
-
Other symptoms as directed by your provider.
