Tummy Trouble? Gastroparesis With Diabetes
If you have diabetes and nausea, constipation, and low blood sugar have left you feeling chronically crummy, gastroparesis may be the reason. It's a condition that is found most often in individuals with long-standing or poorly controlled diabetes, explains Spyros Mezitis, MD, of Lenox Hill Hospital in New York City. And it occurs because the nerves in a person with diabetes just aren't working as well as they would in a person without diabetes.
When the nerves that stimulate the stomach muscles to function aren't working properly, the stomach doesn't empty as it should. In a healthy person, food proceeds through the intestines after a meal, but in someone with gastroparesis, the stomach doesn't efficiently unload its contents. And if the lower esophageal sphincter is open (it's normally closed to prevent regurgitation of the stomach contents) the contents of the stomach come back up to the esophagus and cause the person to regurgitate stomach acid.
"And if the nerves don't stimulate the muscles of the stomach, then the muscles don't pump the food further down the intestinal pipe," Mezitis explains. "This becomes a huge problem since the person can't digest food properly."
When food stays in the stomach, it causes a variety of symptoms such as nausea, constipation, feelings of bloating, and even vomiting, explains Kellie Rodriguez, MSN, CDE, CPT, director of patient education at the Diabetes Research Institute. Gastroparesis can also cause dangerously low blood sugar in an individual with diabetes.
"This happens because if the insulin works faster than the food gets absorbed, low blood sugar is the result," she explains.
Gastroparesis is not uncommon in individuals with diabetes, but it's still "a fairly rare disease," says Melissa Bagloo, MD, of New York-Presbyterian Hospital/Columbia Medical Center in New York City. "About 15 percent of all diabetics are symptomatic for gastroparesis," she says.
While gastroparesis is chronic, it's also treatable. Doctors may advise patients to:
- Eat small meals and eat more frequently, Rodriguez says. "And you'll want to make sure it is a well-cooked meal since that means less work for the stomach," she says. Some patients are advised to eat six small meals a day.
- Stay well-hydrated. "If the person is not absorbing the food that well, it's easy to become dehydrated," Rodriguez explains.
- Consider oral medications. Motility agents that help the muscles in the stomach to work normally are effective to a certain degree, Mezitis says. "In a mild to moderate case, the person feels better, though in a very bad case, the medication may not be as effective," he explains.
- Get your blood sugar into the normal range. Having a normal blood sugar over the long haul may help this condition.
- There are some surgical options to treat gastroparesis as well, Rodriguez says, though surgery, as she says, is a "more severe" approach. It's an option doctors may try when other treatments don't work.
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