When Diabetes Causes Stomach Problems

Over time, diabetes can affect many parts of your body. One of those is the vagus nerve, which controls how quickly your stomach empties. When it's damaged, your digestion slows down and food stays in your body longer than it should.

This is a condition called gastroparesis. It can make you feel queasy and vomit. It's also bad for your blood sugar levels.

Although it's more common in people with type 1 diabetes, people with type 2 can also get it.

Most people with gastroparesis have had diabetes for at least 10 years and also have other complications related to the disease.

Symptoms

You may have:

• Heartburn or reflux (backup of stomach contents into the esophagus)
• Nausea
• Vomiting (in severe cases, this may happen daily)
• Trouble controlling blood sugar
• Feeling full quickly when eating
• Abdominal bloating
• Poor appetite and weight loss

Complications

Food that stays in your stomach too long can spoil and lead to the growth of bacteria.

Undigested food can harden and form a lump called a bezoar. It can block your stomach and keep what you eat from moving into the small intestine.

Gastroparesis can make it hard to control diabetes. When food finally does leave your stomach and enters the small intestine, your blood sugar goes up, too.

Throwing up can also leave you dehydrated.

Diagnosis

Your doctor will ask about your symptoms. They’ll also do a physical exam, and they may check your blood sugar. They might also suggest other tests.

Barium X-ray: You drink a liquid (barium), which coats your esophagus, stomach, and small intestine and shows up on X-rays. This test is also known as an upper GI (gastrointestinal) series or a barium swallow.

Barium beefsteak meal: You eat a meal with barium in it, and the doctor uses an X-ray to watch how long it takes you to digest the food. That tells your doctor how quickly your stomach empties.

Radioisotope gastric-emptying scan: You eat food that has a radioactive substance in it. Then you lie under a scanner that detects the radiation. If the scan shows that more than half of the meal is still in your stomach after 1.5 hours, you have gastroparesis.

Treatment

Although there is no cure, you can manage gastroparesis and its symptoms.

Controlling your blood sugar helps. Ask your doctor if you should change when and how often you use insulin, and check your sugar levels more often.

Also, talk with your doctor about whether you should stop or change medications that might worsen gastroparesis. These include antidepressants, high blood pressure drugs, and certain diabetes treatments.

For some people with gastroparesis, medications can help:

• Dimenhydrinate (Dramamine), an over-the-counter antihistamine, helps prevent nausea and vomiting.
• Domperidone (Motilium) manages problems in your upper digestive system that are linked to gastroparesis.
• Erythromycin, an antibiotic, also helps your stomach to move food out.
• Metoclopramide (Reglan) makes your stomach muscles to move, which helps food leave your system. It may also prevent nausea and vomiting.
• Ondansetron (Zofran) blocks chemicals in your brain and stomach that cause nausea and vomiting.
• Prochlorperazine (Compazine) helps control nausea and vomiting.

With a procedure called gastric electrical stimulation, a surgically implanted device sends out brief, low-energy impulses to your stomach to help against nausea and vomiting.

In extreme cases, you may need a feeding tube. A surgeon will put a special tube through your abdominal wall directly into your small intestine. You "eat" specially made liquid meals through the tube instead of food going through your stomach.

Diet Changes

When you have diabetes, one of the best ways to help control the symptoms of gastroparesis is to vary when and how you eat. Instead of three times a day, you can have six small meals. You'll have less food in your stomach, so you won't feel as full. It'll be easier for the food to leave your system, too.

Also, pay attention to the texture of food. Liquids and things that are easy to digest are a good idea. For example, choose applesauce instead of whole apples.

Avoid foods that are high in fat, which can slow down digestion. Watch out for fiber, which takes longer for your body to process.

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