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Am Fam Physician. 2008;77(12):1703-1704

See related article on gastrointestinal complications of diabetes.

What is gastroparesis?

During digestion, your stomach normally adds acid to the food you have eaten and your stomach muscles move the food toward your small bowel (also called the small intestine) (see drawing). If you have gastroparesis (GAS-tro-puh-REE-sis), your stomach takes longer to move the food. Sometimes, you get too much bacteria in your stomach or food collects in your stomach and causes blockages.

Gastroparesis is usually caused by nerve damage from diabetes. One of every 10 to 20 people with diabetes has symptoms of gastroparesis.

What are the symptoms?

The symptoms vary, but can include heartburn, nausea, vomiting, and feeling full sooner than normal. You might eat less because eating may make you feel uncomfortable. You could feel bloated, lose weight, or have trouble keeping your blood sugar steady.

How do I know if I have it?

Your doctor will ask you about your symptoms and history and will examine you. You may need some tests to make sure you don't have any blockages, or to see how long it takes food to move out of your stomach.

How is it treated?

  • Controlling your diabetes. With gastroparesis, food is absorbed slowly. You may need to adjust your insulin doses and see your doctor regularly.

  • Changing your diet. Instead of having three big meals a day, you may need to eat less food more often. For example, you could eat six small meals a day. Having less food in your stomach at one time will help your digestion. Small meals also make you feel less full. You should drink more liquids and eat foods that are easy to digest (for example, eat applesauce instead of whole apples). You should avoid foods high in fat or fiber because they can slow your digestion.

  • Medicines. If changing your diet does not help, your doctor may give you medicine (for example, metoclopramide [one brand: Reglan] or erythromycin). The medicine may help you digest food faster or help with your nausea. If you have any side effects from these medicines, talk to your doctor right away.

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