Gastroparesis: That Gut Feeling (Part 1)

A couple of weeks ago, we looked at celiac disease, an often-overlooked but increasingly prevalent digestive disorder that can be seen in people with diabetes. Along that same line, a complication of diabetes that, too, often gets overlooked is gastroparesis. While technically a form of neuropathy, gastroparesis refers to delayed stomach emptying due to damage to the vagus nerve (the nerve that helps the ear, tongue, larynx, pharynx, and abdominal organs work), as well as damage to the muscles in the stomach.

What causes gastroparesis?
Diabetes is the most common cause of gastroparesis, although other factors may play a role, such as stomach surgery, infection, eating disorders, certain medications, Parkinson disease, and hypothyroidism. Gastroparesis can affect people with both Type 1 and Type 2 diabetes, and usually appears after a long time of high blood glucose levels. High blood glucose levels, in turn, can damage both the vagus nerve and the muscles of the stomach, causing them to malfunction.

Gastroparesis can also make managing diabetes more challenging due to the effect on stomach emptying; delayed stomach emptying can make it harder to control blood glucose levels.

How many people with diabetes get gastroparesis?
About one in five people with Type 1 diabetes will develop some degree of gastroparesis. People with Type 2 diabetes have a lower risk.

What are symptoms of gastroparesis?
Some of the most common symptoms of gastroparesis are:

Vomiting can occur several hours after you’ve eaten, before food is fully digested. Some people may vomit without having had eaten at all. The severity of symptoms can vary from person to person. And some people do fine with liquids but not with solid food, for example.

Food that stays in the stomach too long can lead to overgrowth of bacteria. Usually, the gut contains healthful bacteria that help keep the bad bacteria in check, but this balanced can be disrupted by fermenting food in the stomach.

Another problem that can result from gastroparesis is the formation of bezoars. Think of a bezoar as almost like a hairball (you cat lovers will know what I mean!)—except made out of undigested food. Bezoars can cause nausea and vomiting and worsen gastroparesis, because they can block food from passing from the stomach into the small intestine. Bezoars can sometimes be life-threatening, too.

How is gastroparesis diagnosed?
If you have any of the above symptoms and think you may have gastroparesis, talk to your health-care provider. There are a number of ways to diagnose this condition and rule out other conditions, as well. You may not have all of these tests, by the way:

Your health-care provider may order other tests, too, such as a barium X-ray of your stomach, magnetic resonance imaging (MRI) of your abdomen, or an electrogastrogram, which measures electrical signals in your stomach (much like an electrocardiogram measures electrical signals in your heart).

Next week: Treatment for gastroparesis.

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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