Diabetes Education and Research Center
Frequently Asked Questions about Diabetes
What is gastroparesis? What treatments are available for it?
Gastroparesis is a type of nerve damage that affects the stomach. Food is not digested properly and does not move through the stomach in a normal way. Gastroparesis is one form of diabetic neuropathy which tends to appear late in the course of the disease. Symptoms associated with gastroparesis include:
- Early satiety (feeling of fullness)
- Nausea
- Vomiting
- Stomach enlargement (distention)
- Abdominal discomfort
- Loss of appetite
Before any treatments are introduced, a diagnosis of gastroparesis must be confirmed. Conditions such as ulcer, gastritis, or gastric cancers should be ruled out. Your physician or a specialist (in this case a gastroenterologist or a diabetologist) is equipped to conduct tests which can verify the presence of gastroparesis.
Once a diagnosis is confirmed, gastroparesis may be treated by:
Initially (and Throughout)
- Moderating blood sugars. High blood sugars alone have been shown to inhibit GI motility. Conversely, control of blood glucose levels may improve gastric function.
Behavioral Therapy
- Eating several, small meals spaced throughout the day instead of fewer, larger meals. Large quantities of food or fluid consumed in a short period will aggravate symptoms.
- Consuming a low-fat diet. Fat slows emptying of contents from stomach.
- Avoiding fibrous fruits and vegetables which, when left undigested, contribute to formation of dense masses in the gut.
- Trying not to lie down for two hours after eating. Take a walk or engage in some moderate activity which requires you to remain upright for about a half hour after eating.
Drug Therapy
- Metoclopramide (brand name Reglan) was the drug of choice for diabetic gastroparesis but has fallen into disuse. The newest and most potent drug for treating gastroparesis is cisapride (brand name Propulsid). Cisapride's dose and schedule are similar to Reglan's (one 10 to 20 mg pill taken a half hour before meals), but it comes with a better safety profile.
- Erythromycin duplicates the action of a hormone responsible for GI motility. It has been found to be useful for some patients with gastroparesis.
Gastroparesis is a chronic condition. Treatment should be tailored to an individual's needs. We advise you to consult with your physician concerning your needs.
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