Gastroparesis: A Holistic Approach to Healing
December 11, 2024
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Ever wonder what would happen if your stomach decided to take a break from its job, leaving food to linger longer than it should?
For those living with gastroparesis, this puzzling phenomenon is an ongoing challenge. In this blog, we'll shed light on gastroparesis, from its underlying causes to navigating its nutritional and lifestyle management and improving quality of life.
Understanding Gastroparesis:
• Diabetic gastroparesis is a type of gastroparesis that happens in people with diabetes. It causes delayed stomach emptying without blockages, lasting at least 3 months.
• This condition occurs due to nerve damage from diabetes, impairs the stomach's ability to empty properly.
• If not managed, it can complicate diabetes care by causing unstable blood sugar levels.
• Incidence of type 2 diabetes is more common than type 1, so gastroparesis is seen more frequently with this type.
What Causes Diabetic Gastroparesis?
- Chronic High Blood Glucose Levels and Nerve Damage:
• Hyperglycemia (blood glucose > 200 mg/dL) in poorly controlled diabetes is associated with diabetic gastroparesis.
• Chronic hyperglycemia can lead to neuropathy or nerve damage, contributing to gastroparesis, which does not improve with better glycemic control.
• Acute hyperglycemia can also cause delayed gastric emptying but is often reversible with improved blood sugar management.
Understanding The Mechanics:
- Normally, the stomach contracts to break down food and move it into the small intestine. But in diabetic gastroparesis, these contractions are weak or irregular, causing delayed stomach emptying.
- Chronically high levels of blood glucose in diabetes damage the nerves controlling stomach muscles (particularly the vagus nerve), disrupting the stomach's contractions.
- As a result, the stomach contracts less often, contractions between the stomach and intestines become irregular, and the stomach's exit (pylorus) may spasm, delaying stomach emptying.
Symptoms of Diabetic Gastroparesis:
• Feeling full shortly after starting a meal
• Feeling full long after finishing a meal
• Nausea
• Vomiting
• Appetite loss
• Excessive bloating
• Frequent belching
• Upper abdominal pain
• Heartburn
How is Gastroparesis Diagnosed?
Symptoms alone cannot diagnose gastroparesis. A gastric emptying study is essential.
1. Gastric Emptying Study Methods:
• Gastric Emptying Scintigraphy: Involves ingesting a meal with a small amount of radioactive material and taking regular scans to track stomach emptying.
• Gastric Emptying Breath Test: Involves consuming a meal with a non-radioactive substance and collecting breath samples over time to measure gastric emptying.
• Wireless Motility Capsule: A small capsule transmits data on pH, pressure, and temperature as it travels through the GI tract, providing a comprehensive view of gastric motility.
2. Further Examination if Gastroparesis is Confirmed:
• Upper Gastrointestinal (GI) Endoscopy:
◦ If slow gastric emptying is detected, an upper GI endoscopy may be performed to rule out physical obstructions.
◦ A flexible tube with a camera is inserted through the mouth to visualize the upper GI tract, identifying any structural issues such as ulcers, tumors, or strictures.
Complications That Arise with Gastroparesis:
• Fluctuations in Blood Sugar: Delayed stomach emptying can make it challenging to predict when glucose from food will enter the bloodstream, leading to unpredictable blood sugar levels.
• Bezoar Formation: Undigested food can accumulate in the stomach, forming bezoars that can cause blockages in the digestive tract.
• Nutritional Deficiencies and Malnutrition: Difficulty in absorbing nutrients from food can result in malnutrition, leading to deficiencies in essential vitamins and minerals.
• Dehydration: Persistent vomiting or inadequate fluid intake due to gastroparesis can lead to dehydration.
• Gastrointestinal Symptoms: Symptoms such as nausea, vomiting, bloating, gastric reflux, and abdominal pain can significantly impact the quality of life.
Management of Diabetic Gastroparesis:
The initial approach to treating gastroparesis involves lifestyle modifications. Achieving optimal glycemic control is crucial to minimize the effects of hyperglycemia, which can worsen delayed gastric emptying.
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