The stomach normally contracts in order to move its contents down to the small intestine. And this process is generally controlled by the ninth cranial nerve or the vagus nerve . When the vagus nerve is damaged, muscles in the stomach and intestines may not function properly and may result in gastroparesis. Gastroparesis is defined as a disorder characterized by the stomach taking a long time to empty its contents.
Gastroparesis and low blood sugar and high blood sugar are often linked together because of the fluctuation in sugar levels that are usually seen in these patients. This is often due to the time variation of the digestion process that occurs with the said condition.
Many factors may lead to the development of gastroparesis. These include viral infections, surgery that may affect the vagus nerve, and use of medications which may slow down digestion. Diseases involving the nervous system, like Parkinson’s disease and metabolic disorders, may also cause gastroparesis. But one of the most common risk its development is diabetes. In uncontrolled diabetes, the presence of high blood sugar levels can cause changes and damage to the nerves, including the vagus nerve, and blood vessels.
Aside from sugar level fluctuations, gastroparesis signs and symptoms also include pain in the upper part of the abdomen, lack of appetite, acid indigestion or heartburn, vomiting and nausea. Affected patients also easily become full with little food intake. Absorption of nutrients may likewise be affected, thus, patients may lose weight. The severity of symptoms usually vary among patients. Patients presenting with these symptoms are often diagnosed based on their medical history, blood tests and imaging tests, like x-ray, ultrasound and endoscopy. Physicians may further request for additional tests like the breath test and gastric emptying scintigraphy.
Patients are usually managed depending on their disease manifestation. They may be given medications which increase stomach contractions and thus, promote gastric emptying faster. Aside from medications, patients are also provided with instructions on the foods that they can and cannot eat. For instance, their portion sizes and eating frequency is changed, and foods rich in fiber and fats should be avoided as these are often difficult to digest.
In patients with diabetes as well as gastroparesis, the aim of treatment is to improve digestion and control sugar levels. Physicians may make changes in medication schedule and may ask patients to have regular monitoring of blood sugar levels, as gastroparesis and low blood sugar level frequently occur together.
Severe cases of gastroparesis often require surgery for the insertion of a tube for feeding. This usually delivers medicines and food directly to the small intestines for faster absorption into the circulation. Researches are continually being done to discover other means of management that will benefit patients with gastroparesis.