Do you guys know anything about dIabetic gastroparesis?

Dr. David Erani


Yes. Gastroparesis is defined by delayed gastric emptying in the absence of any mechanical obstruction. To put it more simply, food stays in the stomach longer than normal even though nothing is physically blocking its path. Diabetes is among the causes of gastroparesis, along with prior gastric surgery and certain neurologic and rheumatologic conditions. Symptoms of gastroparesis may include feeling full, bloating, belching, abdominal pain, nausea, and vomiting after meals. These symptoms have been found to be present in 5% to 12% of people with diabetes. Even more people may have slow gastric emptying without apparent symptoms. People who develop diabetic gastroparesis typically have had diabetes for several years and have already developed other complications such as retinopathy, neuropathy, and nephropathy. The diagnosis is made by establishing delayed gastric emptying and ruling out mechanical obstruction. The former can be done by various tests including the stable isotope breath test, ultrasonography, MRI, or scintigraphy which is considered the gold standard. While symptoms may be mild or even absent, in extreme cases, they may be debilitating. People with gastroparesis may be unable to maintain adequate nutrition. In some cases, they may require a feeding tube to get adequate nutrition. The delayed gastric emptying of gastroparesis can also complicate diabetes management making it more difficult to dose meal-time insulin appropriately. In severe cases, treatment can be difficult. Medicines such as metoclopramide and erythromycin can help. Cisapride is another drug that has been useful in treating gastroparesis, however because of an association with a heart rhythm abnormality called torsades de pointes, it was voluntarily taken off the U.S. market in 2000. It is available in the U.S. through a compassionate-use program for people for whom other drugs have not been effective.

December 31, 2012 at 11:12 am