Vomit

Can sugar cause stomach pain? Bloating in diabetes

Case: 23-year-old Xiao Wang suddenly developed symptoms of nausea, vomiting and abdominal pain in the early morning hours. Since these pains were truly unbearable, he was taken by taxi to the hospital. When the doctor questioned him, Xiao Wang said that a few hours ago he had eaten with his friends at a roadside cafe, and that when he vomited there were food residues, no signs of gastrointestinal bleeding was not present, so the doctor decided that it was acute gastroenteritis. However, Xiao Wang, who took some gastrointestinal drugs, became increasingly worse. The next day, Xiao Wang came to the hospital again, and after a blood test, it was found that his blood sugar level had reached 28 mmol/L. He was diagnosed with diabetic ketoacidosis.

Usually, when people experience sudden stomach pain, they think that the food at the restaurant or takeaway today is not very fresh, and this has led to indigestion. Several trips to the toilet, several glasses warm water and there are no problems. But for people with diabetes, this idea is not true. If you experience acute pain in your abdomen, or if it bothers you frequently, this means that your body is giving you a danger signal. If ignored, it can lead to very serious consequences.

Four main causes of painto herin the abdomen of diabetic patients.

There are many causes of abdominal pain. Chinese medicine believes that exogenous factors, unhealthy diet, emotional disorders and weak yang can cause abdominal pain. Diabetic patients should first think about the following four causes when experiencing abdominal pain.

Diabetic ketoacidosis.

Diabetic ketoacidosis (DKA) is one of the acute complications diabetes According to the “Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition),” diabetic ketoacidosis is often manifested by loss of appetite, nausea, vomiting, and abdominal pain. They may be accompanied by headaches, irritability, lethargy and other symptoms. In patients with diabetes, these symptoms may be misinterpreted as manifestations of acute gastroenteritis due to abdominal pain, as in the case of Xiao Wang, which is not uncommon.

Side effects of hypoglycemic drugs.

Some hypoglycemic medicines may also cause gastrointestinal side effects intestinal tract, such as abdominal pain, the most common among them are α-glucosidase inhibitors, mainly because they inhibit the absorption of glucose in the small intestine, which leads to excess sugar in the intestine and increased bacterial activity in the intestine. This leads to increased gas production, which causes bloating, abdominal pain, diarrhea and other problems. In addition, metformin and other hypoglycemic drugs can cause not only bloating and abdominal pain, but also other reactions from the gastrointestinal tract.

Chronic pancreatitis.

Chronic pancreatitis is a common disease of the pancreas in the work of gastroenterologists; among their patients there are many elderly people. who are also at risk for diabetes and therefore often have both diabetes and chronic pancreatitis. If diabetic patients experience symptoms of indigestion, upper abdominal pain, lower back pain, anorexia, etc., they should go to the hospital in time to prevent the development of pancreatitis.

Polyneuropathy.

Diabetes can lead to disruption of autonomic regulation. In case of damage to vegetative nerve endings gastrointestinal tract, “diabetic gastroparesis” may occur. The gastrointestinal tract is innervated by the autonomic nervous system. Because of this, there may be disturbances in the regulation of gastrointestinal secretions. Gastric emptying is delayed, food remains in the stomach longer than expected, and symptoms such as vomiting and bloating appear. In addition, bowel dysfunction can cause persistent constipation, diarrhea, or alternating diarrhea and constipation.

Regardless of the cause, people with diabetes should go to the hospital for evaluation and treatment if they experience abdominal pain.

Mistakes in diagnosing ketoacidosis.

It should be noted that diabetic ketoacidosis (DKA) has the specific presentation of abdominal pain and sometimes gastrointestinal symptoms such as nausea and vomiting. These symptoms may be associated with acute gastroenteritis, acute pancreatitis, acute cholecystitis and acute appendicitis. Clinical symptoms of patients with acute stomach, requiring surgery and DKA are extremely similar, and their symptoms are often misdiagnosed, delaying the initiation of treatment.

The Guidelines for the Diagnosis and Treatment of Hyperglycemic Crisis in China notes that patients with DKA often (>50%) suffer from nausea, vomiting, and diffuse abdominal pain. Patients with abdominal pain should be carefully evaluated because abdominal pain may be the result of DKA (especially in younger patients).

Diabetic ketoacidosis is an acute metabolic complication caused by acute insulin deficiency in the human body, which has an acute onset and a high mortality rate. Initial manifestations are general weakness, polydipsia, polyuria, rapid breathing and the smell of rotten apples from the mouth. At further development events appear severe symptoms dehydration, the amount of urine excreted decreases, dry mucous membranes and skin appear, retraction eyeballs and the pulse quickens. Lethargy appears, level blood pressure falls, limbs become cold, with late treatment, all types of reflexes weaken or even disappear and eventually coma occurs.

Therefore, in patients with diabetes, especially type 1 diabetes, when abdominal pain occurs, the very first thing to think about is whether there is ketoacidosis. Those who may have this condition should promptly check the level of ketone bodies in their urine. If they are there, you need to check the ketone bodies in the blood.

Diabetics are more likely to complain of problems related to the digestive tract than people without the disease diabetes mellitus. Of course, not all digestive problems are closely related to diabetes, but the disease does contribute to some problems.

As is known, one of the complications of diabetes mellitus is diabetic neuropathy. It, in turn, can manifest itself in disturbances in the motility of the stomach and intestines, which causes unpleasant consequences. Abnormal stomach function caused by diabetes is called diabetic gastroparesis. It even affects up to 50% of all diabetics.

An aggravating factor is the vicious circle effect that can form - diabetes leads to digestive disorders, and these can lead to increased abnormal glycemia.

Gastroparesis: general information

For proper digestion, the work of the gastrointestinal tract should resemble an orchestra playing - all organs need to perform their role correctly and on time. If one of them hits a wrong note, the entire symphony of nutrient absorption suffers. One of these “false notes” may be gastroparesis.

With gastroparesis, contractions of the stomach muscles are weakened, which leads to food retention inside it. This disrupts the next stages of digestion and develops symptoms that can seriously affect the patient's quality of life, including its physical, emotional and financial aspects. The most common are idiopathic (the causes of the disease are unknown) and diabetic gastroparesis.

What is gastroparesis

Gastroparesis is a violation of gastric motility, in which its functioning fails. The stomach is important body digestive system a person who, by contracting his muscles, crushes solid food and pushes it into small intestine at the required speed. In gastroparesis, these muscle contractions are slowed, causing stomach contents to become trapped in the lumen.

Although gastroparesis is relatively rare disease, its symptoms can be quite debilitating. Patients often complain that nausea, discomfort and abdominal pain interfere with work, communication and other aspects of active life.

Gastroparesis is considered a violation of peristalsis, since with it there are no physical barriers to the exit of food from the stomach.

Causes

In approximately 36% of cases, the cause of this disease cannot be determined. Gastroparesis is then called idiopathic.

Known etiological factors for slowing gastric motility include:

Diabetic type of gastroparesis - develops due to damage to nerve fibers by elevated blood glucose levels.
Complications of operations on the stomach and other organs - gastroparesis develops due to damage or intersection of the vagus nerve
Certain medications – for example, narcotic pain relievers, some antidepressants.
Neurological diseases - for example, Parkinson's disease, multiple sclerosis.
Scleroderma - gastric motility slows down due to damage to the stomach muscles
Stress.

Symptoms

Symptoms associated with gastroparesis can vary in severity. Most often observed:

Nausea.
Vomit.
Bloating.
Early saturation.
Feeling of fullness in the stomach after eating.
Abdominal pain.

Vomiting with gastroparesis usually develops after eating. However, in severe cases of the disease, it can occur without eating; this is due to the accumulation of secretions in the stomach. Because the stomach does not grind food, vomit usually contains large pieces of food.

Important! In severe cases, the ability to digestive tract digestion of food, which can lead to nutritional deficiencies, weight loss, dehydration and exhaustion. Symptoms of gastroparesis can affect daily life, leading to feelings of fatigue, bad mood, energy deficiency, tension.

This may cause vicious circle– more severe symptoms cause anxiety, which, in turn, leads to an even greater deterioration of the condition. Many people with gastroparesis experience depression.

Clinical picture

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Symptoms of gastroparesis can also be observed with other diseases of the digestive tract, so additional examinations are necessary to clarify the diagnosis.

Diagnostics

To confirm the diagnosis, use various methods examinations – laboratory and instrumental.

Blood tests

Although blood tests cannot confirm the presence of gastric motility disorders, they can be useful in assessing nutritional deficiencies and also help rule out other diseases. In addition, if a person has diabetic gastroparesis, they need careful monitoring of their blood sugar levels.

X-ray examination

To identify slow evacuation of gastric contents, the patient is given a barium solution to drink, after which the speed of movement of this is studied using X-rays. contrast agent along the digestive tract.

Fibroesophagogastroduodenoscopy

This examination is carried out using a flexible endoscope with a light source and a camera, which is inserted through the mouth into the esophagus, stomach and duodenum. Using fibroesophagogastroduodenoscopy, doctors can detect any structural abnormalities and perform a biopsy.

Radioisotope research

This is the gold standard for measuring the rate of gastric emptying after a meal. The patient eats a special food that contains a small amount of safe radioactive substance. This radioisotope allows doctors to use a scanner to determine the rate of gastric emptying.

Scanning is usually carried out at hourly intervals over a period of 4 hours. The diagnosis of gastroparesis is established if more than 10% of the radioisotope remains in the stomach 4 hours after eating.

Breath test

The patient eats food with a non-radioactive isotope. After food is absorbed in the small intestine, the isotope enters the bloodstream and is excreted through the lungs. Its amount in exhaled air allows doctors to calculate the rate of bowel movements.

Antroduodenal manometry

During this examination, a thin tube is inserted into the stomach, with which the pressure in it is measured during muscle contractions during the digestion of food. The same measurement is carried out in the duodenum.

Attention! This examination allows doctors to evaluate gastric motility and duodenum, detect violations of muscle coordination. In most patients with gastroparesis, eating causes either infrequent contractions (caused by nerve damage) or very weak muscle contractions (caused by muscle damage).

Electrogastrography

During this examination, it is recorded electrical activity stomach using electrodes attached to the surface of the skin of the abdomen. U healthy people there is a regular electrical rhythm of the stomach, the strength of the impulses increases after eating. In patients with gastroparesis, this rhythm is abnormal or there is no increase in impulse strength after eating.

Studying peristalsis using a wireless capsule

The patient swallows a small electronic capsule that is specially designed to measure gastric emptying time. As it moves through the digestive tract, the capsule sends information to a receiver that the patient wears on his belt or neck. This information is downloaded to a computer and analyzed.

Ultrasound examination

Ultrasound examination can reveal structural or functional disorders of the stomach, and also helps to exclude others possible reasons symptoms observed in the patient.

Approximately 29% of patients with gastroparesis also have diabetes. Elevated blood glucose levels associated with diabetes can damage nerve fibers, which control the muscles of the stomach, which interferes with its normal emptying.

In turn, diabetic gastroparesis can also complicate glycemic control. One of the main goals of treating this disease is to improve blood glucose control.

Idiopathic gastroparesis

Idiopathic gastroparesis is a disorder of gastric motility with an unknown cause. This is the most common type of delayed gastric emptying.

Previous infections are considered possible causes of idiopathic gastroparesis. Acute gastroenteritis is associated with the onset of this disease, Epstein-Barr virus, rotavirus. People with post-viral gastroparesis continue to suffer from nausea, vomiting, and early satiety after other symptoms of infection have disappeared.

Who is doing the treatment?

Internists and gastroenterologists treat delayed gastric emptying.

Diet

Dietary changes are one of the first treatments for gastroparesis. The stomach empties faster when there is less food in it, so patients are advised to eat smaller meals more often. Eating soft and liquid foods that do not require chopping also makes it easier to empty the stomach.

Fats cause the release of hormones that slow down gastric peristalsis, so it is recommended to eat foods low in fats. In addition, doctors advise that the diet should contain little fiber, as it also slows down stomach emptying.

Advice! Food must be chewed very thoroughly to make it easier for the stomach to grind it. Food should be consumed with sufficient quantity water, since the liquid contents pass faster into the intestines. However, in people with severe gastroparesis, large amounts of fluid can also make the condition worse.

Patients with gastroparesis should eat most of their meals in the morning. They should not lie down for 4-5 hours after their last meal, as supine position gravitational assistance to gastric emptying is eliminated.

Patients should not drink carbonated drinks or alcohol, or smoke.

Treatment

If the causes of gastroparesis can be identified, treatment should be aimed at eliminating or controlling them. For example, diabetic gastroparesis can be improved by lowering blood glucose levels; patients with hypothyroidism should take thyroid hormones.

In addition, it is carried out symptomatic treatment.For this purpose the following are used:

Cisapride is enough effective drug for the treatment of gastroparesis. However, its use is limited by the development of dangerous complications, so it is prescribed only to patients with severe gastroparesis that cannot be treated with other methods.
Domperidone - promotes contraction of the stomach muscles and its emptying.
Metoclopramide – effectively enhances the muscle activity of the stomach. The use of this drug may also be limited by its side effects.
Erythromycin is a common antibiotic that, when used in low doses, stimulates contractions of the muscles of the stomach and small intestine.

For these drugs to work, they must reach the small intestine, where they are absorbed into the bloodstream. In severe gastroparesis, there is virtually no gastric emptying, so medications must be administered intravenously. For such management, Metoclopramide, Erythromycin or Sandostatin are used.

If dietary changes and drug therapy do not improve symptoms, electrical stimulation of the stomach may be used. This method consists of implanting a small device under the skin of the abdomen, from which two electrodes go to the stomach muscles.

Electrical impulses coming from this device along the electrodes stimulate muscle contraction, which speeds up gastric emptying. Electrical stimulation is turned on and off externally. Severe cases of gastroparesis are sometimes treated with an injection of botulinum toxin into the valve between the stomach and duodenum. This drug relaxes the pylorus muscles, which allows food to pass out of the stomach. The injection is performed through an endoscope.

Sometimes patients with gastroparesis need surgery to create a larger opening between the stomach and intestines. These surgeries can relieve symptoms of the disease by allowing the stomach to empty more quickly.

Enteral nutrition

If patients are unable to maintain adequate nutritional intake with regular food, they may need enteral therapy. There are several methods for doing this.

Important! Temporary enteral nutrition is carried out through a nasojejunal tube inserted through the nose into the hungry intestine. When food is inserted into this tube, it immediately enters the small intestine, where it is absorbed.

For continuous enteral nutrition, jejunostomy is used - surgical removal of the opening of the hungry intestine to the anterior abdominal wall.

Complications

Gastroparesis can cause the following complications:

Severe dehydration.
Exhaustion of the body.
Formation of bezoars in the stomach.
Fluctuations in blood glucose levels.
Deterioration in quality of life.

Prevention

Most cases of gastroparesis cannot be prevented. Since diabetic gastroparesis is a consequence of neuropathy caused by diabetes mellitus, patients with this disease are advised to carefully monitor blood glucose levels to prevent deterioration of gastric motility.

Gastroparesis develops when the muscles or nerves of the stomach are damaged, which slows down its peristalsis. At the same time, the grinding of food in the stomach is disrupted and its release into the small intestine is slowed down, which leads to nausea and vomiting. Treatment for gastroparesis usually includes diet, drug therapy, electrical stimulation or surgery.

Diabetic gastroparesis, symptoms and treatment

Gastroparesis is a condition in which the ability of the stomach to clear its contents is reduced, but there is no blockage. Why gastroparesis occurs is unknown, but the condition is usually caused by processes that disrupt nerve signals in the stomach. The disease often becomes a complication of diabetes mellitus.

Risk factors

The disease is provoked by:

diabetes;
systemic sclerosis;
gastrectomy (during surgery to remove part of the stomach);
drugs that block nerve signals (such as anticholinergic drugs)

How does the condition manifest?

Symptoms of the disease include:

hypoglycemia (in patients with diabetes mellitus);
bloating;
premature abdominal fullness after eating;
weight loss;
nausea;
vomit.

How is the disease treated?

A patient with diabetes should always monitor their blood sugar levels. Prescribed medications such as:

cholinergic drugs that can act on acetylcholine receptors;
erythromycin;
metoclopramide, which helps clear the stomach.

In some cases it is necessary to perform surgical procedure, create an opening between the small intestine and the stomach. This allows food to move through the gastrointestinal tract more easily (gastroenterostomy surgery).

Gastroparesis in diabetes

It is generally accepted that gastroparesis is chronic disease, it cannot be cured, but you can try to control the course of the disease. You will have to control your blood sugar levels. The doctor prescribes medications that will not worsen the condition of the stomach, in particular, antidepressants, medications to lower blood pressure, as well as medications to treat diabetes. Consult your doctor about which medications are best to take.

Medicines for gastroparesis: expected and side effects

Prescribed drugs can stimulate contraction of the stomach muscles, improve gastric emptying, and reduce nausea and vomiting. But you may encounter side effects such as fatigue, anxiety, loss of coordination, depression, and drowsiness.

Attention! Antibiotics can improve gastric emptying, increase muscle contraction, and help move food from the stomach to the intestines. Side effects There may be vomiting, nausea, stomach cramps. For gastroparesis, antiemetic drugs are sometimes prescribed to reduce nausea and vomiting.

Medical nutrition indicated

It is very important for diabetic patients to control the symptoms of gastroparesis and monitor how and what you eat. It is better to eat six small meals a day. In this case, there will be less food in the stomach, oversaturation will not appear, and the food will leave the stomach faster.

Gastroparesis in diabetes mellitus

Gastroparesis is a stomach disorder that can affect people with type 1 and type 2 diabetes. With gastroparesis, the stomach takes too long to empty (delayed gastric emptying). Controls the movement of food through the gastrointestinal tract nervus vagus. If the vagus nerve is damaged or stops working, the muscles of the stomach and intestines do not work normally and the movement of food slows or stops.

Just as with other types of neuropathy, diabetes can cause damage to the vagus nerve if blood glucose levels remain high for a long period of time. High blood sugar causes chemical changes in the nerves and blood vessels, which carry oxygen and nutrients to the nerves.

Symptoms

Signs and symptoms of gastroparesis include the following:

heartburn;
nausea;
vomit undigested food;
feeling of fullness in the stomach when you start to eat;
weight loss;
bloating;
unstable blood glucose (sugar) levels;
lack of appetite;
spasms in the wall of the stomach.

These symptoms can be mild or severe, depending on the person.

Complications

Gastroparesis can make diabetes difficult to manage. Those. Blood glucose levels will be difficult to regulate. When food that has been retained in the stomach enters the small intestine and is absorbed, blood glucose levels increase.

Tip!If food lingers in the stomach, it can cause problems such as bacterial growth because the food is fermented. In addition, food can harden into hard masses called bezoars, which can cause nausea, vomiting and gastric obstruction. Bezoars can be dangerous if they block the passage of food into the small intestine.

Diagnosis confirmation

The diagnosis of gastroparesis is confirmed by one or more tests:

Barium X-Ray Study

After fasting for 12 hours, you will drink a thick liquid containing barium, which coats the inside of the stomach, making it easily visible on x-rays. After 12 hours of fasting, your stomach will be empty. If x-rays show food in the stomach, gastroparesis is likely.

If the X-Ray shows an empty stomach but your doctor suspects you have delayed bowel movements, you may need to repeat the test another time. One day, a person with gastroparesis may digest food normally, giving a falsely normal test result.

Barium nutrition

You will eat food that contains barium. Barium allows the doctor to watch your stomach as it digests food. The amount of time it takes for the barium to be digested and released from the stomach gives the doctor an idea of how well the stomach is working.

Important: This test can help find bowel problems that do not show up on a liquid barium x-ray test. Some diabetics with gastroparesis often digest liquids well, so a food barium test is more effective.

Radioisotope scanning of the stomach

You will eat food that contains a radioactive isotope, a slightly radioactive substance that will show up on the scan. The radiation dose from a radioactive isotope is small and not dangerous. After eating, you will lie under a machine that detects a radioactive isotope and shows the food in your stomach. The isotope also shows the rate of gastric emptying. Gastroparesis is diagnosed if more than half of the food remains in the stomach after two hours.

Treatment

The best treatment for gastroparesis in diabetics is strict blood sugar control. You need to follow a diet, timely insulin injections and take sugar-lowering pills. In severe cases, gastroparesis is treated with intravenous nutrition or a feeding tube.

If you have gastroparesis, your food is absorbed more slowly. To better manage your blood glucose levels, you may you will need to try the following:

take insulin more often;
take insulin after meals, not before;
Check your blood glucose levels after meals and adjust your insulin dose when needed.

Your doctor will give you specific instructions depending on the course of your illness. Used in the treatment of gastroparesis various drugs. Consult your doctor to find the best treatment.

Nutrition

Changing your eating habits can help control gastroparesis. Your doctor or dietitian can give you specific instructions to improve your condition. You need to eat less food at one time. For example, eating six small meals a day instead of three large meals. You also need to eat slowly, sit straight after eating, and take a walk after eating.

Your doctor may also recommend eliminating high-fat, high-fiber foods. Fatty foods slow down digestion. Fiber can also be difficult to digest, contributing to the formation of bezoar deposits. Depending on the severity of the illness, your doctor may recommend trying liquid meals or prescribing medications to speed up digestion.

Feeding tube

If other methods don't work, surgery may be needed to insert a feeding tube. This process is called jejunostomy. The tube is inserted through the skin on the abdomen and into the small intestine. A feeding tube allows nutrients to be placed directly into the small intestine, bypassing the stomach.

Please note: You will receive special liquid food for use with the tube. Jejunostomy is especially useful when gastroparesis cuts off the nutrients and medications needed to regulate blood glucose levels.

By avoiding the source of the problem (the stomach), nutrients and medications are directly delivered to the small intestine. You will see that these products are quickly digested and delivered to the bloodstream. Jejunostomy may be temporary and is used only when necessary when the paresis is severe.

It is important to note that in most cases, gastric paresis is chronic condition. Treatment helps you manage your gastroparesis so you can be healthy and comfortable.

Diabetic gastroparesis

Diabetic gastroparesis refers to the incomplete cessation of stomach activity against the background of a consistently increased percentage of sugar in the blood over a long period of time. At the same time, there is also a negative effect on the activity of the patient’s nervous system. The disorders comprehensively affect the nerves responsible for muscles and the formation of acids and enzymes. Complications affect the stomach, intestines or the entire gastrointestinal tract.

If pathology occurs, signs may be as follows:

At the beginning of the disease, the patient experiences heartburn and belching after eating.
Even with a small amount of food eaten, the stomach feels overly full.
Nausea, vomiting, bloated stomach, abnormal bowel movements.

However, most often the signs indicating diabetic gastroparesis are individual. A particularly unpleasant moment for diabetics when pathology manifests itself is the difficulty of maintaining a constant sugar level even with proper nutrition and a measured lifestyle.

Treatment

If the diagnosis confirms diabetic gastroparesis, treatment should begin with a review of the lifestyle and strict control of sugar in the body. The main cause of the development of pathology is the vagus nerve.

During the treatment process, it is necessary to restore its operation. As a result, the stomach functions normally, the condition of the heart and blood vessels stabilizes.

There are several ways to treat diabetic gastroparesis:

Use of medications.
Specially designed exercises performed after meals.
Review of diet.
Drawing up a gentle menu, switching to liquid or semi-liquid food.

Together, these methods stabilize the activity of the stomach well and regulate sugar levels.

Idiopathic gastroparesis

Idiopathic gastroparesis is one of the main types of pathology. The disease is a functional stomach disorder when the evacuation function is impaired. The pathology is manifested by attacks of nausea, which occur several times a week.

Short-term vomiting is possible, occurring at least once every week, or its stereotypical attacks, lasting up to 7 days and occurring at least three times a year. Stomach dysfunction can be observed against the background of psychopathological conditions, such as depression.

Diagnostics

To confirm the disease, certain tests are performed to show the speed of food movement and gastric emptying. Typically, the tests use a small amount of radioactive substance added to foods taken. X-rays, radioisotope examinations, breathing tests, ultrasound examinations and other techniques may be performed. After which the specialists prescribe the necessary treatment.

Treatment

When a doctor confirms a patient has gastroparesis, treatment is prescribed depending on the patient's condition.

Typically this is:

Review of diet, prescription of diet. The menu includes products containing a small proportion of fiber and fat.
The daily portion is divided into several small doses.
Medicines are used to speed up gastric emptying by increasing contractile activity. This may be the drug erythromycin, domperidone or metoclopramide. At the same time, erythromycin belongs to the group of antibiotics, but its properties help speed up the movement of food in the stomach.
Surgical intervention, in which a feeding tube is inserted into the small intestine. The method is used for particularly severe pathologies.

Gastroparesis and diet

In order for the stomach to be freed from food as quickly as possible, it is necessary to reduce the portion sizes, but eat them more often. The diet for gastroparesis includes liquids and foods that do not require thorough chewing, which subsequently facilitates the process of food leaving the stomach.

Advice! Fatty foods should be eliminated from the diet as much as possible, since fat provokes the production of hormones that slow down the functioning of the stomach. If the disease is severe enough, the patient may be placed on a liquid diet exclusively.

Treatment with traditional methods

Is it possible to treat gastroparesis? traditional methods? The fact is that to date no method has been developed that will relieve the patient of symptoms completely and completely improve intestinal functions. However, there are a number of herbs that help improve digestion.

Angelica, dandelion and artichoke leaves, and orange peels help to quickly break down food. Chinese hawthorn prevents food from stagnating in the intestines. Drinking a glass of water with a lemon drop before lunch helps set the body up for better perception.

However, all methods are strictly individual. In any case, before taking patented drugs and using traditional recipes, you should consult your doctor.

What is gastroparesis?

Gastroparesis is a disorder in which the stomach takes longer to empty after eating. The long-term results may be unpleasant and possibly severe symptoms due to disruption of the digestive process.

What causes the disease?

Gastroparesis occurs when the nervous system of the stomach is damaged or stops working. Most common cause is diabetes mellitus. Other causes may include certain nervous system disorders such as Parkinson's disease or stroke, as well as certain medications such as tricyclic antidepressants, blockers calcium channels and sleeping pills.

What are the symptoms?

Symptoms may be transient and most often appear during or after eating. They may be:

Feeling of fullness in the stomach after a few bites of food.
Frequent bloating.
Belching and hiccups.
Heartburn or vague stomach pain.
Nausea or vomiting.
Loss of appetite and weight.

Symptoms can range from mild to severe. Severe symptoms Gastroparesis may be alleviated by treatment with drugs that speed up gastric emptying (increase gastric contractility). In some particularly severe cases, it is necessary to insert a feeding tube into the small intestine.

A person with gastroparesis may also experience episodes of increased or reduced level blood sugar Gastroparesis may be suspected in a person with diabetes who has symptoms related to the upper digestive tract or blood sugar levels that are difficult to control. Controlling them may reduce the symptoms of gastroparesis.

How is it diagnosed?

The diagnosis is confirmed with one or more tests that show how quickly food leaves your stomach. Such tests include radioisotope scanning gastric emptying.

Important! During this test, you must drink liquid or eat some food that contains a small amount of radioactive material. This substance appears as a special image that allows the doctor to see the food in your stomach and evaluate how quickly it leaves your stomach.

How is it treated?

Treatment for gastroparesis depends on the severity of the condition and may include the following:

Eating several small meals a day rather than three large meals a day.
Eating foods low in fiber and fat.
Medicines that speed up gastric emptying (increase gastric contractility), such as metoclopramide (Cerucal), domperidone, or erythromycin. Erythromycin is an antibiotic, but it also helps speed up the emptying of food from the stomach.
Surgical insertion of a feeding tube into the small intestine in cases of severe gastroparesis.

How to cure diabetic gastroparesis

Gastroparesis is very common among people with type 1 and type 2 diabetes, a condition characterized by high blood sugar levels. Unfortunately, diabetic gastroparesis is a chronic condition that cannot be cured. However, there are methods to relieve symptoms and return to a relatively normal life.

Treatment at home

Pay attention to your blood sugar levels. High level Blood sugar slows down the digestion process because the vagus nerve, which stimulates digestion, is inhibited. High sugar levels cause chemical disturbances in blood vessels and nerves, which reduce cellular respiration and metabolism, slow down the evacuation of stomach contents, and impair digestion.

Therefore, it is important to control your sugar levels. Normal level Blood sugar ranges from 70 mgdl to 110 mgdl. If your blood sugar level is higher than normal, insulin must be administered to normalize it.

Buy a glucometer at any pharmacy to monitor your sugar levels. You will need a finger prick to get a drop of blood. Dip the meter test strip into a drop of blood and wait a few seconds while the device calculates your sugar level.

Take insulin after meals, not before. If you suffer from diabetic gastroparesis, take insulin after meals rather than before. This will delay the effect of insulin and keep sugar at a constant level. Consult your doctor before attempting this method.

Eat small, frequent meals. To relieve the symptoms of diabetic gastroparesis, it is better to eat small, frequent meals rather than large, infrequent meals. This is due to the fact that small portions are more easily absorbed by the body than large ones.

Attention: Small portions of food prevent a rapid rise in sugar, which reduces the need for insulin. This is very important for maintaining health against the background of diabetes. Try eating six small meals a day instead of three large ones.

Chew your food thoroughly. Chewing thoroughly food facilitates digestion. This is due to the fact that such mechanical processing of food facilitates the penetration of gastric juice and speeds up digestion.

Chewing food thoroughly involves chewing small portions of food for a long time and swallowing slowly. Take your time while eating. Try not to be distracted from eating by watching TV, reading or talking to someone. Distraction from food contributes less chewing thoroughly food.

Tip: Avoid foods rich in fiber. Fiber-rich foods worsen the symptoms of diabetic gastroparesis because fiber increases stress on the stomach. Such foods slow down digestion and a person feels full for a longer time.

Avoid foods rich in fiber, such as oranges, broccoli, apples, wheat, beans, nuts, cabbage. Avoid foods rich in fat. Fats are difficult for the body to digest because they do not dissolve in water. Digesting fats is a long process, so it is important to avoid fatty foods, especially if you have a weak stomach.

Food, rich in fats: Butter, cheese, processed meats, canned goods and any fried meat. Don't lie down after eating. It is important to remain upright for at least two hours after eating. This will make digestion easier due to gravity.

Take a walk or do some light exercise after eating. This will facilitate digestion and the stomach will evacuate its contents faster. Physical exercise will increase the uptake of glucose by cells for energy. This will provide the body with the energy necessary for the digestion process.

Medical treatment

Take medications that improve gastrointestinal motility. If you are diagnosed with gastroparesis, your doctor will prescribe medications to increase gastrointestinal motility. For example:

Ranitidine. This drug increases the motility of the digestive tract. It is usually prescribed at a dosage of 1 mg per kilogram of body weight twice a day in tablet form.

Metoclopramide. This drug stimulates muscle contraction, accelerates the evacuation of stomach contents and stimulates appetite. The drug relieves nausea and vomiting. Taken half an hour before meals and before bedtime at a dosage of 10 mg three times a day.

Your doctor may prescribe a liquid diet. Doctors sometimes recommend a liquid diet for diabetic gastroparesis because liquid foods are easier to digest. These products include cereals, tea, milk and soups.

IN difficult situations, the doctor may prescribe intravenous injections a drug, for example, dextrose in saline with a frequency of 1 liter every eight hours. Such measures can be applied in cases of severe disruption of the absorption of nutrients by the body.

Try electrical stimulation of the stomach muscle. In this method, a battery-powered device is implanted into the abdomen. The device delivers an electrical impulse to the stomach muscle. This stimulates the stomach, promotes the evacuation of stomach contents and relieves nausea and vomiting.

Important! The device is inserted surgically under general anesthesia. Surgical treatment of diabetic gastroparesis is used only in severe situations. Also applies surgery, in which a tube is inserted into the jejunum to deliver nutrients directly into the intestines.

A catheter may be used to deliver nutrients. In some cases, parenteral nutrition may be used in people with diabetic gastroparesis. The catheter is fixed in the chest vein and through it the necessary nutrients are delivered directly into the bloodstream.

Symptoms

Feeling full. The first symptom of diabetic gastroparesis is a feeling of fullness almost all the time. This is due to a slowdown in the evacuation of stomach contents. After digestion in the stomach, food after some time enters the intestines.
When your stomach is full for a long time, you feel full and full.
Bloating. Bloating is caused by slower evacuation of stomach contents into the intestines due to disruption of the stomach muscles. The stomach muscles are involved in the digestion process. When the stomach muscles do not work well enough, digestion and gastric emptying are slowed down. Gases accumulate in the stomach. The formation of gas causes a feeling of bloating.
Feeling sour in the throat. The feeling of sourness in the throat is caused by regurgitation of food into the esophagus due to slower evacuation of stomach contents into the intestines. The esophagus connects the mouth and stomach. When the contents of the stomach stagnate and do not pass further into the intestines, food rises up the esophagus. The contents of the stomach are mixed with aggressive gastric juices, and therefore cause a burning sensation in the esophagus.
Think about it if you feel bloating and discomfort after eating. The feeling of bloating is caused by slow digestion, which allows food to accumulate in the stomach. Gas is usually produced during digestion, but this occurs in the intestines, not the stomach. Slowing the evacuation of stomach contents into the intestines causes gas to accumulate in the stomach and a feeling of discomfort after eating.
Decreased appetite. Decreased appetite is caused by slow digestion, which leads to a prolonged feeling of fullness. The feeling of hunger occurs when the stomach is empty. When the stomach is full, there is no feeling of hunger.
Stomach ache. Abdominal pain is caused by food building up in the stomach and slow digestion. This leads to a feeling of pain and discomfort.
Monitor your blood sugar levels. Diabetic gastroparesis can cause low blood sugar levels. With diabetic gastroparesis, digestion becomes difficult, which means the absorption of carbohydrates into the blood slows down.
Loss of body weight. Because of constant feeling When you are full, your appetite decreases and you eat less, which means you lose weight.

helped me completely get rid of diabetes, a supposedly incurable disease. Over the last 2 years I have started to move more; in the spring and summer I go to the dacha every day, grow tomatoes and sell them at the market. My aunts are surprised how I manage to do everything, where so much strength and energy comes from, they still can’t believe that I’m 66 years old.

Who wants to live a long, energetic life and forget about this forever? terrible disease, take 5 minutes and read.

A characteristic feature Damage to the digestive organs in diabetes mellitus is a long-term latent, asymptomatic course against the background of significant morpho-functional changes. Frequency of lesion various departments the digestive tract is different: low in case of damage to the esophagus and more in case of damage to the intestine.

Lesions of the oral cavity and esophagus in diabetes mellitus

Already in oral cavity processing of the food bolus begins. In the presence of various dental disorders, the beginning of the digestion process is disrupted. Diseases of teeth and gums are generally the first signs of diabetes. They do not allow full mechanical and enzymatic processing of food.

Damage to the esophagus in diabetes mellitus - esophageal neuropathy - is clinically manifested by heartburn and dysphagia, sometimes chest pain. It is rarely diagnosed clinically.

Much more often it is detected using additional instrumental methods - mechanometry and kineradiography. In patients, dilation of the esophagus, a decrease in the strength and speed of peristalsis, a slowdown in evacuation, loss of tone of the gastroesophageal sphincter, and esophagitis are determined.

Complications of diabetes mellitus on the stomach

Changes in the stomach in diabetes mellitus are detected quite often. In almost half of the patients in the initial period of the disease and in the majority of those who have been ill for a long time, manifestations of chronic gastritis or gastroduodenitis are determined.

Newly diagnosed diabetes is characterized by symptoms superficial gastritis with scanty plasma cell, histiocytic and lymphoid infiltration of subepithelial tissue.

With increasing duration and severity of diabetes mellitus, infiltration increases and mucosal atrophy appears. Morphological changes are manifested by a decrease secretory function stomach, flow of hydrochloric acid, pepsin activity in gastric juice.

These changes correlate with the duration and severity of diabetes mellitus and the presence of microangiopathies. In patients with newly diagnosed diabetes mellitus, gastric hypersecretion with increased acidity and pepsitic activity of gastric juice, which is eliminated under the influence of insulin therapy and subsequently decreases, which explains the rarity of peptic ulcers in diabetes mellitus. Clinical symptoms Gastric damage is absent or insignificant. Sometimes patients complain of a feeling of heaviness, fullness of the stomach, belching of air and food, anorexia, nausea, and vomiting of long-consumed food. This is due to a delay in the passage of food from the stomach. These complaints are not dominant and appear only during an additional targeted interview.

Diabetic gastroparesis develops due to a disorder motor function stomach. In most patients it clinical course asymptomatic. The decrease in gastric tone occurs gradually, but acute atony of the organ is possible in diabetic ketoacidosis, after stressful situations, surgical interventions, physical exercise.

Acute atony is manifested by pain in epigastric region, bloating, debilitating vomiting, peritoneal phenomena. It can simulate progressive pyloric stenosis and contribute to the development of gastric emphysema. In patients with gastroparesis, liquid, mucus and food debris are determined in the stomach on an empty stomach.

Gastroparesis is diagnosed using fluoroscopy, pneumogastrography, topopneumography, electrogastrography, electromanometry, which reveal hypomotor disturbances in the contractile activity of the stomach, weakening of peristalsis and a decrease in the rate of evacuation of gastric contents, decreased tone of the cardiac and pyloric sphincters.

With a sharp decompensation of metabolism in patients with diabetes mellitus with concomitant peptic ulcer of the stomach and duodenum, the development of an acute ulcer is observed. Peptic ulcer disease often precedes diabetes mellitus, and with its occurrence it becomes mild in nature and is accompanied by a decrease in pain. The reason for this is a decrease in acid formation and an increase in the content of mucopolysaccharides in gastric juice.

Complications of the disease often cause abdominal pain in diabetes mellitus. They can be short-term as a reaction to food, or indicate pathology. In diabetes, the patient's pain threshold, accordingly, pain is felt already at severe violations. In such a situation, you should immediately contact a doctor who will refer you to necessary diagnostics SD and abdominal cavity. Next, treatment is prescribed based on the patient’s clinical picture. The basis of prevention is compliance with necessary and moderate physical activity.

Complications of diabetes that cause pain

When the pancreas malfunctions and insulin production fails, diabetes mellitus occurs. A very serious disease, complications of which lead to irreversible consequences. Painful sensations In the stomach with diabetes, they can be short-term (they do not hurt for long and go away on their own) and long-term (they signal problems). Factors that provoke abdominal pain in diabetes mellitus are:

stomach and duodenal ulcers;
reaction to drugs with metformin (due to lack of calories in food) and use when drinking alcoholic beverages;
lactic acidosis;
liver diseases;
ketoacidosis;
chronic hepatitis.

It is worth understanding that the sensation of pain in diabetics is dulled, and if such a symptom appears, it means that something is happening in the body. severe complications that require immediate clinical attention.
Diagnosis of abdominal pain in diabetes mellitus

To determine the cause discomfort, an abdominal ultrasound is prescribed.
It is impossible to independently determine the cause of abdominal pain with diabetes. To do this, a series of laboratory research. The first priority is to ascertain the patient's experience of what preceded the onset of symptoms when diabetes began. To do this, an oral interview, palpation and examination of the patient are carried out. Next, the sugar level is measured, the glycemic profile and insulin indicator are determined. A glucose tolerance test is performed and the level of glycosylated hemoglobin is measured. Blood biochemistry is carried out ( laboratory analysis) and urine analysis, Rehberg test and ultrasonography abdominal organs.
ECG, measurements of acetone levels, blood electrolyte composition are done if necessary. Only after these manipulations will the attending doctor be able to see the full clinical picture and prescribe treatment. Diagnostics may not be limited to the tests described, but may include additional studies related to pain. Referrals for diagnostic procedures are issued by the attending physician, based on the patient's medical history and responses.

Treatment and prevention
Treatment of diabetes includes balancing sugar levels and normalizing metabolism. The manifestations of accompanying pain in the abdominal area can be reduced. For this, doctors prescribe acceptable painkillers. It is important to get rid of the disease that causes painful sensations, and continue insulin treatment for diabetes. An important step in treatment and prevention is nutrition:
food intake mode is adjusted;
foods high in carbohydrates are excluded;
fatty, spicy, unhealthy food, confectionery and sweet drinks.

To prevent complications of the underlying disease, it is important to monitor blood pressure.
To prevent complications from diabetes and related diseases, causing pain in the stomach, you need to be systematically checked by an endocrinologist and take independent measurements of your sugar levels. Rest, moderate physical exercise will contribute to a speedy recovery. It is important to monitor blood pressure levels and not leave concomitant ailments untreated. If there are any deviations in your health, you should not postpone a visit to the doctor. Synthetic drugs are prescribed exclusively by the attending physician.

Affects in 1-1.5% of cases. Its motility is impaired, its tone decreases, the esophagus can expand, gastroesophageal reflux often occurs, the mucous membrane becomes inflamed - esophagitis develops. Patients complain of heartburn, a burning sensation in the chest; There may be chest pain similar to angina pectoris, but nitroglycerin does not relieve these pains and even intensifies.

Stomach lesions occur in 30-40% of patients and are most often manifested by functional disorders: changes in motor-evacuation function, slower evacuation of contents, impaired sphincter function, and dilation of the stomach. In severe cases, paresis (decreased tone) and atony (paralysis) of the stomach may develop. The listed conditions cause stagnation of food masses in the stomach, which promotes reproduction pathogenic bacteria and the occurrence of dysbacteriosis.

Insufficient mixing of food with gastric juice, the secretion of which can also be significantly reduced, leads to indigestion. Irregular and slow intake of poorly digested food masses into the intestines, where proteins, fats and carbohydrates are predominantly absorbed into the blood, can be the cause of frequent and at first glance incomprehensible hypoglycemia.

In patients with severe disorders stomach functions Appetite decreases, a feeling of heaviness in the epigastric region appears, heartburn, belching, nausea, worse after eating. With diabetic gastroparesis (decreased stomach tone), patients lose weight. There is a distension of the stomach, and when food is retained, vomiting often occurs. Atrophy of the mucosa, together with paresis or atony, can cause vascular damage and gastric bleeding.

However, many researchers argue that peptic ulcer stomach and duodenum in people with diabetes mellitus is much less common than in people without diabetes. Cases of the formation of stones in the stomach are described, which is associated with stagnation of food masses in it. The tone of the stomach usually decreases gradually, but with diabetic ketoacidosis, acute, rapidly occurring atony (paralysis) of the stomach and intestines may develop, accompanied by acute intense abdominal pain, vomiting, sharp deterioration general condition.

“Acute abdomen” in ketoacidosis is also associated with hemorrhages into the peritoneum (the sensitive membrane covering the outside of the abdominal organs), with irritation of the gastric and intestinal mucosa with acetone and ketonic acids. This dangerous, difficult to diagnose condition may mask other abdominal “catastrophes”, e.g. acute appendicitis, perforation of a stomach ulcer. That's why in case acute pain in the abdomen, which occurs against the background of high blood sugar and the appearance of acetone in the urine, it is necessary to urgently seek medical assistance, do not take antibiotic painkillers!

Intestines also does not remain aloof from autonomic neuropathy and circulatory disorders developing in diabetes, and it suffers most often. Intestinal damage caused by diabetes is called diabetic enteropathy. Patients are concerned about a tendency to constipation, bloating, diarrhea, unstable stool, usually with normal temperature bodies. The most typical development of intestinal damage in diabetes is the development of diabetic diarrhea syndrome, which manifests itself frequent diarrhea, especially at night, with the release of watery feces mixed with mucus.

The urge to defecate occurs more than 5-7 times a day. Simultaneously abdominal pain, flatulence, rumbling, and milk intolerance appear. Diarrhea (i.e. diarrhea) is replaced by persistent constipation. Less commonly, sphincter agony develops, resulting in fecal incontinence, often at night. Naturally, the listed conditions often take patients out of psychological balance. Both doctors and patients should always keep in mind that gastroenterological disorders can cause a worsening of the underlying disease, especially in people taking tableted hypoglycemic drugs.

The human body has not yet been fully studied safety margin, unique ability to self-renew. You are required to help the body regain health. And if you do daily simple recommendations to take care of yourself, carry out self-monitoring (at least to the extent possible), in consultation with your doctor, try to keep your glycemia within limits normal values, take the recommended medications, then rest assured that you will be able to prevent the appearance of the formidable companions of diabetes or prevent their progression when they already exist, and initial stages complications, it is possible to achieve their reverse development.

It is important to observe daily personal hygiene And rational mode nutrition.

Don't overuse hot or cold food to avoid damage to the mucous membranes of the oral cavity, esophagus and stomach.
Fine chew food - then it is better absorbed.
Healthy on an empty stomach and before each main meal 20-30 minutes. drink a glass before meals boiled water at room temperature this will improve the motility of the digestive tract.
It is advisable to eat approximately at the same time, having three main and three intermediate meals, in accordance with the effect of the deployment of glucose-lowering drugs. This diet will ensure a uniform supply of carbohydrates to the blood and prevent the development of hypoglycemia.
If you have to festive feast, where you may not be able to resist and eat more than usual, then, after consulting with your doctor, take 1-2 tablets of enzyme-containing drugs that facilitate the digestion process (mezim-forte, pancreatin).

The diet should be as varied as possible, and be sure to include foods rich in natural vitamins, microelements (chromium, zinc, selenium), and dietary fiber.

Nutricomplex is improving chemical reactions metabolism by supplying cells with amino acids, fiber, enzymes, trace elements and vitamins. The drug slows down the aging process, normalizes body weight, reduces cholesterol levels, improves digestion, stabilizes sugar levels, improves skin and hair condition, and improves immunity.