Did you know that August is Gastroparesis Awareness Month? A less common complication of diabetes, gastroparesis can have a significant impact on quality of life. Read on to learn about:
What is gastroparesis?
Gastroparesis is a condition of delayed (slowed) gastric emptying in the absence of mechanical obstruction (physical blockage). This means that food is slow to move from the stomach into the small intestines.
Symptoms of gastroparesis include:
nausea
vomiting
poor appetite
reflux
bloating
abdominal discomfort (specifically upper abdominal pain)
early satiety (feeling of fullness when eating)
Is there a connection between diabetes and gastroparesis?
While the cause of gastroparesis is often unclear, 29% of gastroparesis cases are believed to be due to diabetes. Exposure to high blood glucose (sugar) levels over an extended period of time can cause damage to our nerves - this is referred to as neuropathy. This can include damage to nerves that control stomach muscles.
Other common causes of gastroparesis include surgery causing damage to the vagus nerve, and viral infection.
How is gastroparesis managed?
Initial management of gastroparesis focuses on dietary changes and improving blood sugar control (in people with diabetes). In cases where symptoms persist, your doctor may prescribe medications such as prokinetics (e.g. domperidone, metoclopramide) to help move food through the stomach and/or antiemetics (medications that help reduce nausea and vomiting).
What dietary changes can help improve gastroparesis symptoms?
Nutrition for gastroparesis focuses on reducing symptoms and maintaining adequate nutrition to support your overall health.
To help improve symptoms of gastroparesis:
Eat smaller, more frequent meals. Larger meals take longer to digest and can make you feel full quickly. Smaller meals will empty from your stomach more quickly.
Chew foods well. Aim to chew all food to a mashed potato consistency. This helps your stomach digest food more quickly.
Stay sitting up during meals and for at least one hour after eating. Avoid lying down soon after a meal to reduce symptoms of reflux.
Limit alcohol intake. Alcohol can make food move out of your stomach more slowly. If you take insulin, alcohol can also increase the risk of hypoglycemia (low blood sugar) up to 24 hours after drinking.
Choose foods that are lower in fibre. Fibre can slow down the digestive process and stomach emptying. High fibre foods should also be avoided because they may remain in your stomach or cause bezoar formation. A bezoar is a mixture of food fibres that can cause a blockage in your stomach (similar to a hairball in a cat) and prevent it from being able to empty well.
Choose foods that are lower in fat. Fat slows stomach emptying. Avoid high fat, fried or greasy foods as these can worsen symptoms.
A note about blood sugar management
If you have diabetes, you may find blood sugar to be less predictable as food can be digested at inconsistent times.
People are different and what works for one person may not work for another. Figuring out what works best for you to keep blood sugar under control may require extra monitoring.
While gastroparesis can make managing blood sugar more challenging, doing your best to meet blood sugar goals may help to decrease gastroparesis problems. High blood sugars directly interfere with normal stomach emptying.
References
Camilleri M, Parkman HP, Shafi MA, et al. Clinical guideline: management of gastroparesis. The American Journal of Gastroenterology. 2013; 108(1), 18–37. https://doi.org/10.1038/ajg.2012.373
Homko CJ, Duffy F, Friedenberg FK, et al. Effect of dietary fat and food consistency on gastroparesis symptoms in patients with gastroparesis. Neurogastroenterol Motil. 2015;27(4):501-8. doi: 10.1111/nmo.12519.
Parkman HP, Hasler WL, Fisher RS. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004. 127(5), 1592–1622. https://doi.org/10.1053/j.gastro.2004.09.055
Vera B, Ari B, Bruce A, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Neuropathy. Can J Diabetes. 2018;42(Suppl 1):S217-S221.
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