Possible Gastroparesis?

[lulu721]

I'm Type 1 diabetic who is having some stomach problems. I was diagnosed with diabetes 6 years ago (when i was 17) and after a month of being diagnosed I started to have these stomach problems. My symptoms were: nausea (this is a big one), burning sensation, always feeling hungry, gas and bloating. I was put on nexium, prevacid and got blood tests and an x-ray done but the meds didnt work and the results for the tests came back normal. After a few months the symptoms went away on its own and stayed that way for 5 years.

Now I'm having the symptoms again. I've had them for 3 months already and it's making my life miserable. I have the same symptoms as mentioned above and the doctor has given me Pantoloc, which doesn't work. I've had blood tests, been tested for ulcer and an ultrasound and everything came back normal once again. I even went to the ER last week and the docs sent me home cause they didnt think it was anything serious. They did suggest that my stomach problems could be due to gastroparesis.

Now, is it possible that I have this? I mean, my sugar levels are in good control but you never know right? I'm waiting for an appointment with a gastroenterologist and just wanted to ask for other people's opinions and advice about this. And does anyone have any tips on how to deal with nausea? It's really debilitating and is interfering with my daily life. Thanks

[Annie62]

I think I just hit the post button too soon--they've changed the format.

Anyway, as you probably know, gastroparesis is quite common with diabetes, especially type 1.  If you haven't already done so, just type in diabetic gastroparesis and you will come up with thousands of articles.  But if your blood sugar levels have been well controlled I don't know how likely it would be that you would have it.  

Both the nausea and bloating are prominent symptoms of gastroparesis.  The feeling hungry isn't, but that could be due to something else.  The burning, if it is in your chest/esophagus and epigastric region could be from reflux.  If your stomach is full of food all the time it promotes reflux back up into the esophagus.  I also have a significant problem with this, although the b.i.d. AcipHex helps with it.  Cutting out certain foods (the ones you aren't supposed to eat if you have GERD) also can help--caffeine, spicy foods, etc.

If you are scheduled to see a gastroenterologist then he might want you to have a gastric emptying scan.  It is done in nuclear medicine, you usually eat a prepared egg sandwich and milk that have radioactive material in them, and they scan you while you lie under a machine to see how quickly the food/drink leaves your stomach.  Depending on the time they can tell whether you have mild, moderate or severe GP.  If it is moderate or severe then you would probably be put on medication to help the food leave your stomach more quickly (promotility drugs).  I take domperidone for this.  It also can help with nausea, although I don't have a significant problem with that like a lot of people with GP do.  

In the meantime you could try eating small meals often/not eat a lot at any one sitting (something you probably already do with your diabetes, anyway), as that helps the stomach empty quicker; don't eat for several hours before going to bed, as that helps with the reflux when you lie down (unless, due to your diabetes, you are supposed to eat at night); and cut down on high-fat foods to lessen symptoms.  Both high-fat and high-fiber foods slow down digestion, but eating low-fiber isn't a healthy diet in general, so I think the best thing to do, instead of cutting out high-fiber foods altogether, is to remove the skins/peel off of veggies/fruits, not eat the pulpy part of citrus, and cook down/soften hard to chew/digest foods like raw cabbage, etc. (although you are cooking the vitamins out as well).  An even better alternative is to put hard to digest foods in the blender so you are retaining the vitamins, although this is time-consuming.  

As far as the nausea, you might try eating ginger (that is supposed to help with stomach upset) and could also ask your doctor to try you on the many different meds for nausea.  Sorry if you already know all this.  You might not even have it, but I saw your post and thought I would respond.  

[lulu721]

Thanks alot for the info. I'm taking domperidone too because that's what the doctor in the ER gave me. It works quite well with my symptoms although not as well as I want it to with the nausea. I have an appointment scheduled on the 25th for an upper gi series so hopefully they shed some light on whatever I have. Thanks again!