6 Symptoms That Suggest Diabetes Is Affecting Your Gut (Gastroparesis)

Gastroparesis is a disorder in which the stomach requires significantly more than its normal 1 1/2 to 2 hours to empty. The delay results in bothersome and possibly serious symptoms because digestion is altered.

What causes gastroparesis?
Gastroparesis occurs when the nerves to the stomach are damaged or don't work. Diabetes is the most common cause. Other causes include some disorders of the nervous system, such as Parkinson's disease and stroke, and some medicines, such as tricyclic antidepressants, calcium channel blockers, and narcotics.

What are the symptoms?
Symptoms are intermittent and most often occur during and after a meal. They include:

• A feeling of fullness after only a few bites of food
• Frequent bloated feeling
• Belching and hiccups
• Heartburn or vague stomach pain
• Nausea or vomiting
• Loss of appetite and weight loss

Symptoms range from mild to severe. Severe symptoms of gastroparesis may improve with treatment using medicines that help the stomach empty more quickly (motility agents). In very severe cases, a feeding tube placed in the small intestine may be needed.

A person with gastroparesis also may have episodes of high and low blood sugar levels. Gastroparesis may be suspected in a person with diabetes who has upper digestive tract symptoms or has blood sugar levels that are difficult to control. Controlling blood sugar levels may decrease symptoms of gastroparesis.

How is gastroparesis diagnosed?
A diagnosis is confirmed with one or more tests that indicate how quickly food leaves your stomach, including a radioisotope gastric emptying scan. For these tests, you will drink a fluid or eat some food containing a slightly radioactive substance. This substance shows up on a special image, allowing a doctor to see food in your stomach and watch how quickly it leaves your stomach.

How is it treated?
Treatment for gastroparesis depends on the severity of the condition and may include:

• Eating several small meals each day rather than three larger meals
• Eating meals that are low in fiber and fat
• Medicine to help the stomach empty more quickly (motility agents), such as metoclopramide (Reglan), domperidone (available in Europe and Canada), or erythromycin. Erythromycin is an antibiotic, but it can also help the stomach empty more quickly.
• Surgery to place a feeding tube in the small intestine, if gastroparesis is severe