Diabetes & The Body

Gastroparesis Can Cause Erratic Blood Sugar Level

Gastroparesis is a disorder that affects the functioning of the stomach. There is delay in emptying of the food contents in the stomach. It is accompanied by feeling of nausea, vomiting, an early fullness when eating, weight loss, abdominal bloating and abdominal discomfort.

Gastroparesis occurs when nerves to the stomach are impaired or stop working. The vagus nerve, which controls the movement of food through the digestive tract, is damaged. The muscles of the stomach and intestines are paralyzed and the movement of food is slowed or stopped.

Gastroparesis is often caused by type 1 diabetes. At least 20 percent of people with type 1 diabetes develop gastroparesis. The vagus nerve can get damaged if blood glucose levels remain high over a long period of time.

Complications of Gastroparesis

The food that lay in the stomach for a long time paves way for fermentation of thee food. The food becomes solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. The condition can get worse if bezoars impede the passage of food into the small intestine.

Gastroparesis can make diabetes worse by adding to the difficulty of controlling blood glucose. When food in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis involves irregular stomach emptying, a person's blood glucose levels can be erratic and difficult to control.

Major Causes of Gastroparesis

• Diabetes
• Postviral syndromes
• Anorexia nervosa
• Surgery on the stomach or vagus nerve
• Medications, particularly anticholinergics and narcotic drugs that slow contractions in the intestine
• Gastroesophageal reflux disease
• Amyloidosis and scleroderma
• Nervous system diseases, including abdominal migraine and Parkinson's disease Metabolic disorders, including hypothyroidism.

Diagnosis

A person might have to go through a series of tests for an accurate diagnosis of gastroparesis. Barium x-ray, barium beefsteak meal, radioisotope gastric-emptying scan, gastric manometry, blood tests, upper endoscopy or an ultrasound is given to confirm.

Treatment

The primary goal for diabetes related gastroparesis is to restore normal blood glucose levels. Treatments include insulin, oral medications, diet, and intravenous feeding in extreme cases.

If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to take insulin more oftenand after food instead of taking it before a meal. It is essential to monitor your blood glucose levels frequently after you eat and alter the time you take insulin.

Oral medications and combination of drugs are used to treat gastroparesis. Meal and food changes can help control gastroparesis. Your doctor or dietitian will give you specific instructions, but you may be asked to eat six small meals a day or live on a liquid diet to make it easy for food to pass through the stomach more easily and quickly.

If other approaches do not work, you may need surgery to insert a feeding tube. The tube, called a jejunostomy tube, allows you to put nutrients directly into the small intestine, bypassing the stomach altogether. A jejunostomy is particularly useful when gastroparesis prevents the nutrients and medication necessary to regulate blood glucose levels from reaching the bloodstream.

Gasstroparesis is most often a chronic condition. Treatment only helps you manage the condition but may not cure.