Part 2 of 3 parts
Treating gastroparesis is important if
you have diabetes and often your diabetes medications will need to be
changed. Gastroparesis can occur when the vagus nerve is damaged by
illness or injury and the stomach muscles stop working normally.
Food then moves slowly from the stomach to the small intestine or
stops moving altogether.
It is known that elevated blood glucose
levels directly interferes with normal stomach emptying. Excellent
blood glucose management is needed to prevent gastroparesis and help
food move through the stomach.
Gastric emptying is unpredictable with
gastroparesis. It causes a person’s blood glucose levels to be
erratic and difficult to control. “The primary treatment goals
for gastroparesis related to diabetes are to improve gastric emptying
and regain control of blood glucose levels. In addition to the
dietary changes and treatments already described, a health care
provider will likely adjust the person’s insulin regimen.
To better control blood glucose,
people with diabetes and gastroparesis may need to
- take insulin more often or change the type of insulin they take
- take insulin after meals, instead of before
- check blood glucose levels frequently after eating and administer insulin when necessary”
Your doctor should give you specific
instructions for taking insulin based on the needs of the individual
and the severity of gastroparesis. It is often suggested that you
eat several liquid or pureed meals per day until gastroparesis
symptoms improve and your blood glucose levels are more stable.
“The problems of gastroparesis can
include
- severe dehydration due to persistent vomiting
- gastroesophageal reflux disease (GERD), which is GER that occurs more than twice a week for a few weeks; GERD can lead to esophagitis— irritation of the esophagus
- bezoars, which can cause nausea, vomiting, obstruction, or interfere with absorption of some medications in pill form
- difficulty managing blood glucose levels in people with diabetes
- malnutrition due to poor absorption of nutrients or a low calorie intake
- decreased quality of life, including work absences due to severe symptoms”
Bezoars is a hard indigestible mass of material, such as
vegetable fibers, or the seeds and skins of fruits, formed in the
alimentary canal.
Important points to keep in mind:
#1. Gastroparesis is a disorder
that slows or stops the movement of food from the stomach to the
small intestine.
#2. Gastroparesis normally
occurs when the vagus nerve is damaged by illness or injury and the
stomach muscles stop working normally.
#3. Idiopathic gastroparesis is
often the diagnosis because the doctors cannot identify the cause,
even with medical tests.
#4. Diabetes is the most common
cause of gastroparesis. Over time, the people with unmanaged
diabetes and have consistent high blood glucose levels cause damage
to the vagus nerve.
#5. The most common symptoms of
gastroparesis are nausea, a feeling of fullness after eating a small
amount of food, and vomiting undigested food (this can occur several
hours after a meal. Other symptoms include gastroesophageal reflux,
pain in the stomach area, abdominal bloating, and lack of appetite.
#6. Gastroparesis is diagnosed
through a physical exam, medical history, blood tests, tests to rule
out blockage or structural problems in the gastrointestinal (GI)
tract, and gastric emptying tests.
#7. Changing eating habits can
sometimes help control the severity of gastroparesis symptoms. A
health care provider may suggest eating six small meals a day instead
of three large ones. When a person has severe symptoms, a liquid or
puréed diet may be prescribed.
#8. Treatment of gastroparesis
may include medications, botulinum toxin, gastric electrical
stimulation, jejunostomy, and parenteral nutrition.
#9. For people with
gastroparesis and diabetes, a health care provider will likely adjust
the person’s insulin regimen.
Jejunostomy is an artificial opening from the jejunum
through the abdominal wall, created for the drainage of jejunal
contents or for feeding.
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