The bowel and intestines of many diabetics work at a slothful pace to empty the contents, thus triggering a host of bothersome symptoms. Such a condition is medically termed as diabetic gastroparesis. Nearly fifty percent of type 1 diabetes patients go through this sickening ordeal on a regular basis.
Tips to Treat Diabetic Gastroparesis
Diabetic gastroparesis is a chronic grave ailment of the stomach afflicting the abdominal muscles and nerves which leads to incomplete and abnormally low emptying or functioning of the stomach.
Treatment approach involves diagnosing and managing the disease which is causing the condition. Diagnosis can be tricky as classic symptoms of gastroparesis like nausea, vomiting and stomach pain can ape several other conditions like gall bladder disease, peptic ulcer disease or irritable bowel syndrome.
It’s a double-ended sword for diabetic gastroparesis patients as unmanaged diabetes could aggravate gastroparesis and vice versa. Improper control over blood glucose levels can have a damaging effect on the vagus nerve that is considered vital for appropriate digestion.
The American Diabetes Association (ADA) suggests increasing the frequency of insulin intake that must ideally be taken after meals. Diabetologists would also advice about routinely checking blood sugar levels following meal times and administering insulin as and when the need arises.
Frequency of Meals
Avoid taxing your stomach by aiming to consume six to eight smaller meals that are spaced closer together rather than three large regular meals in a day. Moreover, drinking plentiful fluids pre, post and during meals facilitates quicker and smoother victual movements through the digestive tract.
It is imperative that one adheres to the below mentioned advice for superior management of diabetic gastroparesis. Patients ought to discuss with their dietician or physician about the daily addition of liquid nutritional supplements that would offer key minerals and vitamins that may be lost from the body due to diabetic gastroparesis.
Foods to Eat
The dietary agenda for this condition might appear daunting, yet the Ohio State University (OSU) Medical Center suggests plentiful food choices that sufferers can enjoy to ensure a well-balanced diet for optimal diabetes management. Starch sources like pastas as well as potato and meats can be passed through a blender along with juiced tomatoes, broths, soup and water for providing necessary nutrition.
It is proven that fiber-rich foods often lead to bezoar formation which is chiefly a compactly packed accrual of non-digested matter which could create abdominal obstruction. Hence, such patients should opt for foods with less fiber content but are nutritionally dense such as well-cooked as well as de-skinned veggies and fruits, poultry, fishes, lean form of grounded beef, egg as well as yoghurt.
Protein-based shake, protein-rich broths, fat-free milk products and juiced tomatoes are widely recommended by dieticians for ensuring sufficient nutritional intake to maintain optimal health and control blood glucose levels. Foods in fluid form like shakes, whole milk, liquid-consistency smoothies and sieved infant food are often recommended by dietitians for people suffering from acute symptoms.
Foods to Avoid
Coconuts, berry, corn and most foods containing seeds should be avoided. Moreover, swallowing chunky pieces is also not desirable. Fried or fatty carbohydrates might slacken gastric emptying and exacerbate symptoms. Fatty or greasy foods should to be avoided as fat is known to innately slow down digestion.
Bezoar-forming fruits like blueberry, raspberry, orange, blackberry, kiwis, strawberry and dry fruits like prune, apricot, raisin, fig and dates ought be avoided by patients. The Pennsylvania State Milton S Hershey Medical Center recommends steering clear of all forms of citrus and tinned fruits bearing skins due to the fibrous presence. Fibrous meats (steak, chop), pulses, raw veggies bearing the skin, cereals and whole grain victuals are difficult to digest.
Avoid cruciferous veggies like broccoli, cabbage, bok choy, cauliflower, cress as they are known to cause flatulence while passing through the digestive tract and linger in the stomach for longer periods of time which can possibly lead to the formation of bezoars.
When dietary amendment fails in treating the condition then some medicines might be prescribed by the doctor for curbing pain, nauseous feeling and vomiting or stimulating the abdominal muscles into active mode.
They are drugs that help to accelerate emptying of the bowel and motility of the intestinal region as well as assuaging gastrointestinal symptoms. Commonly used drugs for diabetic gastroparesis treatment include Metoclopromide, Levosulpiride, Cisapride, Tegaserod, Domperidone and Erythromycin.
Pain can be prominently experienced among several sufferers who did not respond favourably to conservative approach. Narcotic analgesics like Tramadol may be administered either intermittently or chronically to such sufferers. Medicated adhesive skin patches like fentanyl or Methadone are deployed when there’s no improvement in pain with other analgesic medicines.
Drugs like lorazepam, diphenhydramine, prochlorperazine among others work by controlling symptoms of nausea as well as vomiting. However, these drugs fail to have any effect on gastric emptying.
Surgical intervention entails subcutaneous placement of a small pacemaker-like neurostimulator in the stomach wall. The electrodes are then placed into the lining of the abdomen. The signals emanating from the device alter the abdominal nerves and allay niggling symptoms of nausea among patients. Although this therapy approach is effectual but it isn’t a cure-all and eligible candidates are highly selective.
Botulinum Toxin Type A Shots
Plyoric shots of botulinum toxin type A work by inhibiting the release of acetylcholine and producing transitory paralysis after administration into the smooth muscle. Benefits garnered from the procedure are short-term.
It is the final line-of-treatment which is conducted when all the therapy choices have been futile to the patient.
Enteral Nutrition Therapy
Liquefied nutrients are delivered in a direct manner inside the stomach or small intestines through a feeding tube. This therapy approach is generally impermanent and chiefly deployed for people suffering from acute symptoms of the condition or uncontrolled blood glucose levels that fail to be managed by other therapy approaches.
These sufferers are incapable of tolerating any type of foods or liquids. In such patients a jejunostomy(feeding) tube is placed either nasally or orally or directly inside the small intestine via the skin.
As diabetic gastroparesis is usually chronic in nature hence treatment approaches are directed towards providing reprieve from symptoms and managing the condition so that one can be comfortable as well as healthy.
It is an operative procedure wherein the stomach of the patient is either partially or totally excised.