Gastroparesis: The Common Complication Most Diabetics Don't Know About

Since you were diagnosed with diabetes, have you noticed that you have a problem with belching, bloating, and feeling full? A nagging pain you can’t quite identify in the upper abdomen, or heartburn that antacids can’t help? If you do, you might be suffering from diabetic gastroparesis, the most common complication of diabetes that most diabetics don’t know anything about.

A “paresis” is paralysis and “gastro” refers to the stomach. Gastroparesis (gas-tro-par-EES-is) is a kind of paralysis of the upper digestive tract that causes a delay in emptying the stomach into the small intestines. Eventually afflicting up to 50 per cent of diabetics, this overlooked form of nerve damage typically occurs after a long period of poorly controlled blood sugars, at least 5 to 10 years. Not every diabetic who has this problem experiences all its symptoms all the time, but about half of bloating, constipation, diarrhea, nausea, and vomiting in diabetics may be related to this disease.

The way diabetes results in diabetic gastroparesis is by injury to the stomach’s “pacemaker.” The upper part of the stomach, the fundus, collects food and rink. The lower part of the stomach, the antrum, churns the food around in the acidic gastric juices until it is broken up into tiny fragments and ready for release to the duodenum, the forward part of the small intestine.

A healthy antrum releases food about 3 times a minute, its rate controlled by the vagus nerve, the same nerve that controls the speed of the heart. But when the vagus nerve is damaged by years of high blood sugars, it slows down the stomach. Food accumulates and the stomach has to rely more on stomach acids to break up food and gravity to push partially digested food further along.

So what can you do about gastroparesis? Number one, keep your blood sugars in check. Number two, chew thoroughly and use digestive enzymes, like bromelain, when you eat your food.

High-fat foods slow stomach emptying, and high-fiber foods are something you should avoid when symptoms are severe. Eating smaller meals more often may help, too, but you need to adjust insulin, if you take it. Certain South American herbs, like guarana and mate, aggravate gastroparesis, so be careful with energy drinks. Finally, and ironically, the anti-neuropathy drug Elavil (amitriptyline) makes gastroparesis worse.