Monday, December 31, 2007

Gastroparesis: Symptoms and treatment

Gastroparesis-(gas-troh-pah-REE-sis) Gastro-means stomach. Paresis means impairment or paralysis. It is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with Type 1 or Type 2 diabetes. This condition happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract and if this nerve is damaged, the muscles of the stomach and intestines don't work normally and the movement of food is slowed or stopped.

If the blood glucose levels of a diabetic remain high over a long period of time the vagus nerve can be damaged because high levels of blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to these nerves.

Some signs and symptoms are:

1. Bloating and pain in belly. May burp a lot(rotten egg smell) and have heartburn.
2. Nausea.
3. Vomiting of undigested food, or dry heaves.
4. An early feeling of fullness when eating.
5. Lack of appetite and weight loss.
6. Erratic blood glucose levels.

A person with this condition may feel fine for days or weeks at a time, but then have hours or days of vomiting. The above symptoms may be mild to severe, depending on the person.

There are several major complications of Gastroparesis. If food lingers in the stomach too long it can cause bacterial overgrowth from the fermentation of food. The food can harden into solid masses called bezoars that may cause pain, nausea, vomiting, and obstruction in the stomach.

It can also make diabetes worse by adding to the difficulty of controlling blood glucose because when stomach emptying is unpredictable, a person's blood glucose level can be erratic.

They can diagnosis Gastroparesis by using Barium tests, Radioisotope gastric-emptying scan, Gastric manometry, and blood tests.

The primary treatment goal for Gastroparesis related to diabetis is to regain control of blood glucose levels. These treatments include insulin, oral medications, and changes in what and when you eat. It is a chronic condition and there is no cure. To help control your blood glucose levels you may need to take insulin more often, or take your insulin after you eat instead of before.

Some of the medications used are Reglan, Erythromycin, and Domperidone.

Changes in your eating habits may help. Some of those changes may be: a) eat six small meals a day instead of three large meals, b) avoid high-fat and high-fiber foods because fat naturally slows digestion and fiber is difficult to digest, c) avoid foods such as figs, berries, apples, oranges, broccoli, brussel sprouts, and green beans because the indigestible parts will remain in the stomach too long and possible form bezoars, d) eat meals more slowly and completely chew food, e) sit up at least an hour after eating.

Please do not self diagnosis. If you have any of these symptoms, please see your doctor. Feel free to print out this information and share it with your doctor.

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