Gastroparesis

Gastroparesis diabeticorum; Delayed gastric emptying

The exact cause of gastroparesis is unknown. It may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes. It can also follow some surgeries.

Risk factors for gastroparesis include:

• Diabetes
• Gastrectomy (surgery to remove part of the stomach)
• Systemic sclerosis
• Use of medicine that blocks certain nerve signals (anticholinergic medicine)

Symptoms may include:

• Abdominal distention
• Hypoglycemia (in people with diabetes)
• Nausea
• Premature abdominal fullness after meals
• Weight loss without trying
• Vomiting
• Abdominal pain

Tests you may need include:

• Esophagogastroduodenoscopy (EGD)
• Gastric emptying study (using isotope labeling)
• Upper GI series

People with diabetes should always control their blood sugar levels. Better control of blood sugar levels may improve symptoms of gastroparesis. Eating small meals and soft foods may also help relieve some symptoms.

Medicines that may help include:

• Cholinergic drugs, which act on acetylcholine nerve receptors
• Erythromycin
• Metoclopramide, a medicine that helps empty the stomach
• Serotonin antagonist drugs, which act on serotonin receptors

Other treatments may include:

• Botulinum toxin (Botox) injected into the outlet of the stomach (pylorus)
• Surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily (gastroenterostomy)

Many treatments seem to provide only temporary benefit.

Ongoing nausea and vomiting may cause:

• Dehydration
• Electrolyte imbalances
• Malnutrition

People with diabetes may have serious complications from poor blood sugar control.

Changes in your diet may help control symptoms. Call your health care provider if symptoms continue or if you have new symptoms.