What Is Diabetic Gastroparesis?

There is no cure, but diabetic gastroparesis can be managed with lifestyle changes and medications. In severe cases, surgery may be recommended.

• Vomiting
• Bloating
• Abdominal pain
• Heartburn
• Loss of appetite or feeling full after eating very little
• Blood sugar fluctuations
• Weight loss

“This nerve damage affects the stomach’s natural rhythm of contractions, leading to gastroparesis,” says gastroenterologist Bryan Curtin, MD, the director of the center for neurogastroenterology and GI motility at Mercy Medical Center in Baltimore.

According to Michael Cline, DO, the medical director of the gastroparesis clinic at Cleveland Clinic, people with gastroparesis almost always have other complications before developing gastroparesis, including nerve damage in the feet and legs and eye or kidney issues.

• Upper Gastrointestinal Endoscopy Dr. Cline says this procedure can identify a partial blockage or anatomy problem that prevents the stomach from emptying. An endoscopy involves placing a long, flexible tube with a camera attached into the esophagus, stomach, and duodenum, which is the first part of the small intestine beyond the stomach.
• Ultrasound This imaging test also identifies blockages or anatomy issues, and it uses high-frequency sound waves to create images of organs and tissues inside the body.
• Scintigraphy This is the next diagnostic step if no blockages or anatomy problems were discovered. It measures how quickly your stomach empties food into the intestine. You eat a light meal that contains a small amount of radioactive material. Then, a technician uses a specialized camera to scan the radioactive material and process it into images. You will be scanned right after you eat, 30 minutes later, and one, two, and four hours later.

  [6]

Since this is a digestive condition, it’s essential to pay attention to which foods are recommended and what to avoid. Focus on low-fiber, low-fat, soft, and well-cooked foods. Research shows that spicy, acidic, and fatty foods can make symptoms worse.

If you’re concerned that eating for gastroparesis might be difficult with the dietary restrictions you already follow to manage blood sugar, your healthcare team can help you create a healthy eating plan that will check all the right boxes.

Medications

• Metoclopramide Metoclopramide increases stomach and intestine contractions and eases symptoms such as nausea, vomiting, heartburn, fullness after meals, and loss of appetite.

  [9]

   This drug has a high risk for tardive dyskinesia if taken for longer than 12 weeks.
• Erythromycin This antibiotic helps the stomach muscles contract more to improve gastric emptying.

  [8]

  The antibiotic azithromycin is sometimes used as an alternative.
• Antiemetics This class of drugs helps prevent and treat nausea and vomiting. Both prescription and over-the-counter (OTC) antiemetics are available, including dimenhydrinate (Dramamine) and bismuth subsalicylate (Pepto-Bismol).

  [10]

• Pain Relievers Your physician may recommend non-narcotic pain relievers for severe abdominal pain.

  [8]

Medical Procedures and Surgery

If your symptoms don’t improve with medication, your physician may recommend gastric electrical stimulation (GES). This procedure involves placing a small, battery-powered device under the skin in your lower abdomen and attaching wires to the stomach muscles. The device sends mild electrical pulses to the nerves and muscles in the stomach, helping stimulate contractions.

• Pyloroplasty This procedure relaxes and expands the opening of the pylorus, the muscular valve that releases food from the stomach. 
• Gastric Bypass Also offered as a weight loss surgery for people with type 2 diabetes who have severe obesity, a gastric bypass removes or closes off part of the stomach and creates a new channel between the stomach and small intestine.

• Check blood sugar regularly.
• Take medicines as prescribed.
• Eat a healthy diet.
• Exercise regularly.
• Manage stress.
• Get enough sleep.
• Reach or maintain a healthy weight.
• Avoid tobacco products.
• See your doctor regularly.

Some food may not be digested at all. This food hardens into a bezoar, a solid mass that sits in the stomach and may cause nausea and vomiting, or even prevent other foods from passing into the small intestine.

• Gastroesophageal Reflux Disease (GERD) GERD is a chronic condition where stomach acid travels into your esophagus and throat, causing irritation and inflammation, a burning chest or stomach pain, nausea, sore throat, and chronic coughing.

  [15]

   
• Intestinal Dysmotility High blood sugar from diabetes can damage the nerves that coordinate the movements of the intestines, too. This is known as intestinal dysmotility.

  [16]

• Diabetic gastroparesis is a digestive condition in which food moves too slowly from the stomach to the intestines, causing symptoms like nausea, vomiting, bloating, acid reflux, and abdominal pain.
• Gastroparesis is a severe complication of diabetes. It develops when the vagus nerve that helps control the digestive system becomes damaged by chronic high blood glucose levels, medications, infections, or abdominal surgery.
• There is no cure for diabetic gastroparesis, but symptoms can be managed by controlling blood sugar through diet and medications. Those same techniques, including exercise, good sleep, and stress management, can also help prevent the disease.