Ever Heard of Gastroparesis? This Disease Is More Common Than You Think

Gastroparesis can be a complication of living with diabetes, and if you have it, it may make managing your blood sugars much more difficult.

By Susan B. Sloane, BS, RPh, CDE

Diabetes is a multifaceted disease that can cause complications at times that affect several areas of the body. Complications are thought to occur more frequently when blood sugars have been out of control for long periods of time, but this particular complication known as gastroparesis does not appear to be as strongly associated with blood sugar control.

Gastroparesis affects stomach emptying. It affects about four percent of people in the United States and has other potential causes besides diabetes, including lupus, thyroid problems, viral infections, cancer, and may result as a complication from bariatric surgery as well.

Diabetic Gastroparesis is actually the result of nerve damage to the vagus nerve, which controls the rate at which the stomach empties. Normally, strong muscle contractions push food through the digestive tract. In this case, since the nerve that controls these muscles has been damaged, food is not processed properly.

Symptoms of gastroparesis include bloating, heartburn, stomach pain, nausea, and vomiting. Treatment for this condition is primarily based on dietary modifications if a patient has mild to moderate gastroparesis.^[1] Dietary recommendations include:

• Eating smaller meals more frequently
• Avoiding foods with a lot of fiber
• Avoiding fatty foods
• Avoiding foods that cannot be chewed adequately such as nuts, seed, corn, and

People who have other digestive issues such as gallbladder disease or irritable bowel may recognize this type of diet plan. It is also best to drink adequate fluids (preferably water) during the meal and to avoid lying down right after eating.

A diagnosis of gastroparesis is confirmed by an endoscopy and other diagnostic procedures as well. Treatment involves dietary recommendations (as previously mentioned) and also can include medications to increase stomach contractions, anti-nausea medications, antibiotics to treat potential infections and even botox.^[2]

The importance of good blood sugar control in patients with diabetes and confirmed gastroparesis is highlighted by the fact that acute high blood sugars can also delay gastric emptying.^[3]

Keeping blood sugars in good control can, without a doubt, be more challenging if you have delayed gastric emptying. For example, you may have low blood sugars until the food actually gets digested, and then get a rapid spike when the food is finally “released” into the system. That is why small, more frequent meals are good to help keep blood sugars as stable as possible.

Gastroparesis can be a challenge, but it is important to understand the symptoms and treatment options. It is not fully known what percentage of patients with diabetes have gastroparesis, as sometimes patients can be asymptomatic. Women are more likely to be affected than men. Interestingly, there seems to be some correlation between gallbladder removal and an increased incidence of gastroparesis.^[4]

If you suspect you may have delayed gastric emptying, check with your healthcare team for follow up and testing. If you have confirmed gastroparesis, frequent blood sugar monitoring will be necessary to help you understand how your body responds to food intake.

As always, knowledge is power and we are here to help you stay well-informed.