• Diabetes
• Digestive Health

The Gastroparesis-Diabetes Connection

When the food you eat enters your stomach, muscles in the stomach wall grind the food into smaller pieces before pushing them into your small intestine to continue the digestion process.

But when you have a condition called gastroparesis – also known as delayed gastric emptying – your stomach muscles don’t work properly and slow digestion. This can cause problems.

Complications from diabetes (Type 1 and 2) play a role in causing gastroparesis for about one out of four people with the gastric condition.

Diabetes and Other Causes of Gastroparesis

Gastroparesis is rare. Only about 10 men and about 40 women out of 100,000 people have the condition, the National Institute of Diabetes and Digestive and Kidney Diseases reports.

Complications from diabetes (Type 1 and 2) play a role in causing gastroparesis for about one out of four people with the gastric condition.

The reason for this: Chronic high blood sugar,which can occur with diabetes, can eventually damage the vagus nerve, which controls the muscles in your stomach and small intestine.

Surgery and some cancer treatments of the chest or stomach can also damage the vagus nerve and cause gastroparesis. And many people with gastroparesis also have one of these conditions:

• Scleroderma
• Hypothyroidism
• Gastroesophageal Reflux Disease (GERD)
• Eating disorders
• Nervous system disorders such as Parkinson disease, migraines and multiple sclerosis
• Amyloidosis, which occurs when amyloids, abnormal proteins, form deposits

Symptoms of Gastroparesis

Signs that you have gastroparesis may include:

• Vomiting undigested food
• Heartburn
• Feeling sick to your stomach
• Losing weight
• Bloated stomach
• Lack of hunger
• Hard to control blood sugar
• GERD
• Stomach spasms

How Gastroparesis Is Diagnosed

Your doctor will talk with you about your symptoms, check your health history and examine you. She may also order blood tests and X-rays to rule out other problems. Other tests may also be needed to confirm your diagnosis such as:

• Upper endoscopy, which provides an inside view of your stomach and duodenum. A thin, flexible tube with a tiny camera on the end is inserted through the mouth.
• Upper gastrointestinal (GI) series, X-rays of the upper GI tract from the mouth to the small bowel. Barium is used to coat the upper GI tract so it will show up clearly on the X-rays.
• Gastric emptying scan, which measures how quickly food leaves your stomach. For the test, you’ll eat a meal that contains a harmless radioactive substance – a tracer. The tracer shows up clearly on scans of your stomach to reveal movement of the food.
• Gastric manometry, which measures pressure of the stomach and small intestine to determine how well the muscles contract
• Wireless capsule study, in which you swallow a wireless capsule that measures stomach emptying
• Scintigraphic gastric accommodation, a test that measures your stomach contents before and after a meal and checks how well your stomach relaxes after you eat

Complications and Treatment of Gastroparesis

Food that remains in your stomach undigested can grow bacteria or harden into lumps. Those lumps can block passage of digested food into your intestine. This may cause nausea or vomiting.

Gastroparesis can make blood sugar control difficult. And it can prevent absorption of vitamins and minerals essential to nourishing your body.

Depending on the severity of your gastroparesis, treatment can include one or more of the following. Your doctor will determine the treatment that is best for you, such as:

• Prescribing medications, such as those that help with blood sugar control, help with symptoms like nausea and vomiting or act on digestive muscles
• Stopping medications that may slow digestion
• Making dietary changes such as eating more frequent, smaller meals; avoiding fatty foods and foods with fiber that are not easily digested (like beans and many fruits and vegetables); and temporarily switching to liquid meals
• Using a feeding tube
• Implanting a gastric neurotransmitter, a device that controls nausea

Source: American Diabetes Association; National Institutes of Health; International Foundation for Functional Gastrointestinal Disorders