Diabetes, Gastroparesis, and Other Stomach Problems
Ttreatment for Gastroparesis in Diabetes
Just like diabetes, gastroparesis is a chronic (long-lasting) condition. This means that while the treatment usually doesn't cure the gastroparesis (or diabetes), you can still manage gastroparesis and its symptoms.
People who have diabetes should try to control their blood sugar levels to minimize the problems of gastroparesis. For instance, if you have diabetes, you may want to change when and how often you use insulin, and check your blood sugar levels more often. And talk to your doctor about discontinuing/changing medications that might worsen gastroparesis, such as some antidepressants, high blood pressure drugs, or certain drugs used to treat diabetes. Talk to your doctor about the medicines you take.
Some patients with gastroparesis may benefit from the following medications and procedures:
- Reglan: You take this drug before you eat, and it causes your stomach muscles to move to help food leave your stomach. Reglan also keeps you from having nausea and vomiting. Side effects include diarrhea and other, sometimes serious, side effects.
- Erythromycin: This antibiotic also causes the stomach to move food out. Side effects include diarrhea and development of resistant bacteria from prolonged exposure to the antibiotic.
- Dramamine (dimenhydrinate): This is an over-the-counter antihistamine that helps prevent nausea and vomiting. Side effects include slight to moderate drowsiness and thickening of bronchial secretions.
- Compazine (prochlorperazine): This conventional medication helps to manage nausea and vomiting. The side effects may be less appealing for chronic, daily use.
- Zofran (ondansetron): This drug blocks chemicals in the brain and stomach that cause nausea and vomiting. Side effects may include headache, fatigue, and constipation.
- Motilium (domperidome): This medication is used to manage upper GI problems associated with diabetic gastroparesis. Side effects may include headache.
- Propulsid (cisapride): This medication is under restriction because dangerous, fast heartbeats can occur. It is used to treat severe constipation and poor stomach emptying by increasing gastric emptying through the gastrointestinal tract.
- Antiemetics: These drugs help control nausea.
- Gastric electrical stimulation: This surgically implanted neurostimulator sends out brief, low-energy impulses to the stomach. Although the mechanism of action is uncertain, findings show that the neurostimulator does help improve nausea and vomiting in those with gastroparesis.
- Gastrostomy-tube decompression/PEJ feeding: With gastrostomy feeding tube placement, a surgeon inserts a tube through the abdominal wall directly into the stomach. The enteral feeding tube allows a means to deliver caloric liquids beyond the stomach.
Diet, Gastroparesis, and Diabetes
If you have diabetes, one of the best ways to help control the symptoms of gastroparesis is to vary when and how you eat. For instance, instead of three meals a day, you can eat six small meals. In this way, there is less food in your stomach; you won't feel as full, and it will be easier for the food to leave your stomach. Another important factor is the texture of food; liquids and low-residue foods are encouraged (for example, applesauce should replace whole apples with intact skins).
With gastroparesis, you should also avoid foods that are high in fat (which can slow down digestion) and fiber (which is difficult to digest).