DIABETIC GASTROPARESIS
Diabetic gastroparesis is a type of nerve damage. Years of high blood glucose levels can be the cause of the nerve damage in diabetic gastroparesis. In this condition, those high blood glucose levels damage the blood vessels that provide the nerves with oxygen and nutrients.
Nerves in the stomach are damaged in this condition. Diabetic gastroparesis slows or stops the normal movement of food through the stomach. This is also called delayed gastric emptying. There can be a variety of symptoms: heartburn , nausea, bloating, lack of appetite, vomiting after eating, uncontrolled blood glucose levels and an early feeling of fullness. These symptoms can range from mild to severe.
People with type 1 diabetes are more likely to have gastroparesis than people with type 2. Studies estimate that about 25 percent of people with type 1 and about 5 percent of people with type 2 have it.
DIAGNOSIS
If you have symptoms of gastroparesis, your health care provider will want to do one or more medical tests to find out if you have it. The two common tests are:
- Barium X-ray. You’ll drink a small amount of barium (a harmless chemical) after fasting for 12 hours. The barium coats the inside of the stomach, making it show up on the X-ray. If the GI tract works normally, the test will show that the stomach contains no food. If you still have food in your stomach, then you may have gastroparesis.
- Barium beefsteak meal. You eat a meal that contains barium. This allows the radiologist to watch your stomach as it digests the meal and how long it takes you to digest it. If it takes too long to digest, this suggests gastroparesis. Your health care provider might want to do these other tests, as well:
- A radioisotope gastric-emptying scan to observe the rate at which your stomach empties food.
- Gastric manometry to measure the stomach’s electrical and muscular activity.
- Blood tests.
GASTROPARESIS TREATMENTS
The most important treatment goal is to get your blood glucose levels under control. Better blood glucose control improves this and other diabetes problems. To get better control, you may need more or different types of diabetes medication. The next goal is to make changes in eating habits. Your health care provider may suggest six small meals a day rather than three larger ones, keeping the liquid parts of meals separate from the solids and/or eating less high-fat and high-fiber foods. There are some medicines that can treat gastroparesis. You and your health care provider need to find the one that works best for you.
- Metoclopramide (Reglan). This medicine makes the muscles of the stomach contract to help it empty food. It also helps reduce nausea and vomiting.
- Erythromycin. This is an antibiotic that helps the stomach empty by increasing the number of stomach contractions.
Diabetic gastroparesis cannot be cured. The goal is to try a variety of treatments to find the ones that work best to keep you healthy and comfortable.
PLAIN OLD HEARTBURN
Heartburn is a problem you might have once in a while or very often. This is true whether you have diabetes or don’t. Heartburn occurs when acid from your stomach comes back up and touches the lining of your esophagus (throat). This causes a burning in the chest or throat. You may even taste acid in the back of your mouth. That’s called acid indigestion. If you have heartburn more than twice a week, it may be a condition called gastroesophageal reflux disease, or GERD. This happens when the muscle that opens and closes between the esophagus and stomach does not close properly. This causes the stomach acid to leak back into the esophagus.
HEARTBURN TREATMENTS
Most people use a combination of changes in lifestyle, over-the-counter medicines and prescribed medicines to treat heartburn.
- Lifestyle changes include: not smoking cigarettes or drinking alcohol, losing weight if needed, limiting large meals, limiting foods and drinks that irritate the lining of the esophagus, not lying down a few hours after meals and elevating the head of your bed 6 inches.
OVER-THE-COUNTER MEDICINES:
- Antacids stop the stomach from making too much acid and help the muscles that empty the stomach work better.
- Foaming agents cover the contents of the stomach with foam. This prevents the acid from coming back up.
- H2 blockers don’t allow acid to be made. They give you short-term relief of heartburn, but shouldn’t be used for more than a few weeks at a time. These are available in two strengths, over-the-counter and prescription.
PRESCRIPTION MEDICINES:
- Proton pump inhibitors relieve heartburn in people who have GERD.
- Prokinetics strengthen the esophageal sphincter and make the stomach empty faster.
If you have heartburn often, ask your health care provider or a Walgreens pharmacist to help find the right treatment for you.
