28 June, 2010

Diabetic Gastroparesis!!

Diabetic gastroparesis is the result of damage to the vagus nerve, which controls the movement of food through the digestive system. In a person with this condition, the stomach takes too long to empty its contents. Symptoms include heartburn, nausea, vomiting undigested food, and weight loss. In most cases, treatment does not cure the problem.It often occurs in people with type 1 diabetes or type 2 diabetes. -- it is usually a chronic condition.

Signs & Symptoms

Heartburn
Nausea
Vomiting of undigested food
An early feeling of fullness when eating
Weight loss
Abdominal bloating
Erratic blood glucose levels
Lack of appetite
Gastroesophageal reflux
Spasms of the stomach wall.

Treatment options

Dietry pattern

Taking small frequent meals
try several liquid meals a day until your blood glucose levels are stable
avoid high-fat and high-fiber foods

Pharmacotherapy

Metoclopramide - Stimulates stomach muscle contractions to help empty food. It also helps reduce nausea and vomiting. Metoclopramide is taken 20 to 30 minutes before meals and at bedtime. Side effects of this drug are fatigue, sleepiness, and sometimes depression, anxiety, and problems with physical movement.

Erythromycin - This antibiotic also improves stomach emptying. It works by increasing the contractions that move food through the stomach. Side effects are nausea, vomiting, and abdominal cramps.

Domperidone - It is a promotility agent like metoclopramide. Domperidone also helps with nausea.

Newer Options - A gastric neurostimulator has been developed to assist people with diabetic gastroparesis. The battery-operated device is surgically implanted and emits mild electrical pulses that help control nausea and vomiting associated with diabetic gastroparesis.

The use of botulinum toxin has been shown to improve stomach emptying and the symptoms of diabetic gastroparesis by decreasing the prolonged contractions of the muscle between the stomach and the small intestine (pyloric sphincter). The toxin is injected into the pyloric sphincter.

Gastroparesis - other causes

Postviral syndromes
Anorexia nervosa
Surgery on the stomach or vagus nerve
Medications, particularly anticholinergics and narcotics (these drugs slow contractions in the intestine)
Gastroesophageal reflux disease (rarely)
Smooth muscle disorders such as amyloidosis and scleroderma
Nervous system diseases, including abdominal migraine and Parkinson's disease
Metabolic disorders, including hypothyroidism.

3 comments :

  1. This again is a very common symptom mostly overlooked in the presence of other vital symptoms.We actually worsen their symptom by giving metformin and alpha glu inhibitor.

    ReplyDelete
  2. Nice Blog! Well most of your content and image is original and informative. /many thanks for sharing this, cheers.
    Signs Of Diabetes

    ReplyDelete
  3. thanks a lot steffi for ur encouragement. u can update me with any interesting information regarding diabetes or its complications. i will update it in my blog along with ur name. thanks!!

    ReplyDelete

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