Diabetic gastroparesis: Symptoms, Treatment & medicines
Diabetic gastroparesis
Diabetic gastroparesis is a condition that affects the digestive system of individuals with diabetes. It is characterized by delayed gastric emptying, which means that the stomach takes longer than normal to empty its contents into the small intestine. This delay can cause symptoms such as nausea, vomiting, bloating, abdominal pain, and feeling full after eating only small amounts of food.
Symptoms of Diabetic gastroparesis
Symptoms of diabetic gastroparesis include nausea, vomiting, early satiety, bloating, abdominal pain, loss of appetite, heartburn, unintentional weight loss, and erratic blood glucose levels. These symptoms may worsen after eating, especially after consuming foods that are high in fat and fiber. Malnutrition and dehydration may also occur due to difficulty in eating and drinking enough.
Causes of Diabetic gastroparesis
Diabetic gastroparesis is caused by damage to the vagus nerve, which controls the movement of food through the digestive system. The exact cause of the nerve damage is not completely understood, but it is believed to be related to high blood sugar levels. Other possible causes of gastroparesis include:
- Surgery on the stomach or intestines
- Certain medications such as opioids and antidepressants
Infection - Neurological conditions
- Multiple sclerosis or Parkinson’s disease
In some cases, the cause of gastroparesis may be idiopathic, which means it is unknown. Individuals with diabetes are at a higher risk of developing gastroparesis, especially those with poorly controlled blood sugar levels. It is important to manage blood sugar levels and consult a healthcare professional if you experience any symptoms of gastroparesis.
how to diagnose Diabetic gastroparesisy?
Diagnosis of diabetic gastroparesis may be challenging as it shares some of its symptoms with other conditions, such as peptic ulcers, inflammatory bowel disease, and GERD. A combination of tests is often used to help diagnose the condition.
- Blood tests: Blood tests may be done to check for electrolyte imbalances, blood glucose levels, and signs of infection.
- Gastric emptying study: This test involves eating a meal that contains a small amount of radioactive material and then having imaging scans taken over several hours to see how quickly the food empties from your stomach.
- Upper endoscopy: This procedure involves inserting a thin, flexible tube with a camera into your mouth and down your esophagus to examine your stomach and small intestine.
- Electrogastrography (EGG): This test involves placing electrodes on your skin to measure the electrical activity in your stomach and can help to evaluate the contractions of your stomach muscles.
- Wireless motility capsule: This test involves swallowing a small capsule that measures the movement and pressure of food as it passes through your digestive system
What is the best treatment for Diabetic gastroparesis?
The treatment of diabetic gastroparesis aims to control symptoms, improve gastric emptying, and prevent complications. The best treatment for diabetic gastroparesis depends on the severity of symptoms and the underlying cause. There are some following of treatment options:
- Dietary changes: Eating smaller, more frequent meals, avoiding high-fat and high-fiber foods, and chewing food thoroughly can help reduce symptoms.
- Medications: Medications that stimulate gastric motility such as metoclopramide, erythromycin, and domperidone, can help improve gastric emptying and reduce symptoms. In some cases, antiemetic medications may also be prescribed to help control nausea and vomiting.
- Insulin adjustments: Adjusting insulin doses can help to manage blood glucose levels and improve gastric emptying.
- Gastric stimulation: Gastric electrical stimulation involves implanting a device that delivers electrical impulses to the stomach to improve motility and reduce symptoms.
- Botulinum toxin injection: Botulinum toxin can be injected into the pylorus, the opening between the stomach and small intestine, to relax the muscles and improve gastric emptying.
- Surgery: In severe cases, surgery may be needed to remove the damaged portion of the stomach or to bypass the stomach altogether
Prevention of Diabetic gastroparesis
There are several strategies to prevent or manage diabetic gastroparesis:
- Control blood sugar levels: High blood sugar levels can damage the nerves that control the stomach muscles and delay gastric emptying. Therefore, it is essential to manage blood sugar levels with medication, diet, and exercise.
- Eat small, frequent meals: Consuming smaller meals more frequently throughout the day can help ease the workload on the stomach and promote better digestion.
- Choose easily digestible foods: Opt for low-fat and low-fiber foods that are easier for the stomach to digest.
- Avoid high-fat foods: High-fat foods can slow down digestion and aggravate symptoms of gastroparesis.
- Stay hydrated: Drink plenty of water to help keep the digestive system functioning properly.
- Quit smoking: Smoking can worsen symptoms of gastroparesis and increase the risk of complications.
- Exercise regularly: Regular physical activity can help regulate blood sugar levels and promote healthy digestion.
- Manage stress: Stress can disrupt digestion and aggravate symptoms of gastroparesis. Therefore, it is important to find ways to manage stress, such as through meditation, yoga, or therapy.
Medicines For Diabetic gastroparesis
There are several medications that can be used to treat symptoms of diabetic gastroparesis, including:
- Prokinetic agents: These medications help to improve stomach emptying by stimulating the muscles in the digestive system. Examples include metoclopramide, domperidone, and erythromycin.
- Antiemetic agents: These medications help to reduce nausea and vomiting. Examples include ondansetron, promethazine, and prochlorperazine.
- Antidepressants: These medications can help to relieve symptoms of depression and anxiety, which can worsen gastroparesis symptoms. Examples include amitriptyline and nortriptyline.
- Pain relievers: These medications can be used to relieve abdominal pain associated with gastroparesis. Examples include acetaminophen and ibuprofen.
