Gastroparesis, A Lesser Known Diabetes Complication

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Warnings about potential diabetes complications begin on day one with diabetes.  Health care professionals spell out all that can go wrong with our bodies if we don’t take care of ourselves, and all that can go wrong even if we do. There’s talk of amputation, blindness, heart disease, and neuropathy, and more.

As a teenager with diabetes, I never considered the fact that complications were something that could occur sooner rather than later. After several years of struggling to get a firm grasp on my management, I fell into patterns of insulin omission in hopes of losing weight. The nature of my diabetes care meant that some days I thrived, and other days I flat out ignored my needs. After realizing I was suffering from the eating disorder diabulimia, I made some swift lifestyle changes and my A1C dropped to a healthier range. Unfortunately, the sudden shock to my system created even more nerve damage than what I had experienced while omitting my insulin.

The result? Gastroparesis, a lesser known diabetes complication.

What is gastroparesis?

Gastroparesis, aka paralyzed stomach, occurs when there is damage to the vagus nerve, the longest cranial nerve, that passes through the neck and thorax to the abdomen.

The vagus nerve signals the body to empty the stomach. When this nerve is damaged, the individual will experience a delay in the rate at which their stomach empties its contents. The result of this delay is early satiety, abdominal pain, excessive bloating, nausea, and vomiting. Many describe having gastroparesis to be akin to chronic morning sickness.

How is gastroparesis diagnosed?

Typically, gastroparesis is diagnosed by having a gastric emptying scan. I received mine in the hospital, but this test can be done as an outpatient, as well. The experience involved me eating a plate of scrambled eggs mixed with a radioactive isotope. I was then asked to lie beneath a giant camera and remain very still for a few hours. Through this study, they were able to track the eggs I’d just eaten, taking note of how slowly my stomach moved its contents.

What are the treatment options for gastroparesis?

Unfortunately, there aren’t very many options to treat gastroparesis. There are prescription medications available, but most come with harsh side effects. Many manage their gastroparesis through diet and lifestyle choices, while others must be fed through feeding tubes because they are unable to consume food without regurgitation, or extreme levels of debilitating abdominal pain.

One of the more commonly used medications, metoclopramide, also known as Reglan, comes with a warning that prolonged use may cause neurological issue called tardive dyskinesia, an irreversible movement disorder.

The antibiotic, erythromycin, is also sometimes prescribed in hopes that it will offer better motility for those living with gastroparesis. Sadly, the prolonged use of antibiotics is something that has a significantly negative impact on gut health and the microbiome within, so this option is truly not ideal for those already suffering from GI issues.

For me, living with gastroparesis has been a challenge, but it’s taught me how to listen more closely to my body than ever before. I take a holistic approach to my management, choosing not to use any prescription medications, and instead opting for things like consistent yoga practice and a dedication to finding a diet that works best for me. Unfortunately, the diet suggested for a person living with gastroparesis is low-fiber with an emphasis on avoiding fruits, vegetables, nuts, and seeds that are hard to digest, as well as limiting the amount of fat since that also slows digestion. The diet suggested seems to contradict the one recommended for diabetes, as things like white bread, white rice, and crackers are encouraged.

In my personal pursuit to optimal health, I choose to not make those the main staples of my diet. Instead, I opt for small, frequent meals where I eat mindfully and intuitively recognize what my body can handle. I also try to go for soft or liquid forms of nutrition when I can to further help my efforts to digest as comfortably as possible.

Daily movement is a vital component to my care and deep breathing exercises that stimulate the body’s digestive system are great tools to use, too. I recently became a certified reiki practitioner so that I could explore the benefits of this alternative healing modality. I’m happy to say that I have found both comfort and relief through my experiences with reiki when combined with the other strategies I have implemented.

Finding a balance when you live with both diabetes and gastroparesis can be difficult, but it is also certainly possible. Something I always try to make people aware of is the fact that you don’t need to have lived decades with diabetes to receive a gastroparesis diagnosis. I spent months in limbo, with doctors who had no idea what was wrong with me, because they all assumed I “hadn’t had diabetes long enough.”

Continue to be your own advocate and ask your medical team any questions you may have regarding your diagnosis or treatment plan. I would also suggest finding a supportive group, perhaps online, to turn to when you need to troubleshoot, or just vent about how hard it can be. Just like having diabetes, you are never alone in dealing with your gastroparesis.

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Sarah Macleod

Sarah MacLeod is a diabetes advocate, writer, and certified holistic health coach living in the suburbs of Boston. She was diagnosed with T1D in 2005, at age 15. Sarah has been a PODS leader for the DiabetesSisters since 2013, leading peer support groups for women in Massachusetts, and is also a board member for the diabetes and eating disorder non-profit, the Diabulimia Helpline. She is currently enrolled in a 200-hour RYT program, and is also a certified reiki practitioner. Follow Sarah’s journey as she explores life with chronic illness by checking out her blog, What Sarah Said.

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