Gastroparesis Symptoms: Early Fullness, Nausea, Causes and When to Be Seen

What it involves

MedlinePlus explains that gastroparesis slows the stomach's ability to empty solid food, and that it is not caused by a blockage at the stomach's outlet. The encyclopedia describes it as a chronic condition. The exact cause is often unknown but may involve disrupted nerve signals to the stomach, and it is a common complication of diabetes.

Who this is for

• Adults with early fullness, nausea, bloating or vomiting after meals.
• Patients with diabetes whose blood sugar swings unpredictably after eating.
• People who had stomach surgery or a viral illness before the symptoms began.
• Anyone losing weight without trying because meals no longer sit well.

What to expect

• Questions about meals, vomiting, weight loss, blood sugar, past surgery and medicines that slow the gut
• An exam of the abdomen and blood work, which the practice offers, including blood sugar and electrolytes
• A referral for endoscopy, a gastric emptying study or other digestive tests, since the practice does not perform them
• A plan for meals and symptom control, and a gastroenterology referral if the problem persists

What it feels like

The encyclopedia lists abdominal bloating and pain, nausea and vomiting, feeling full early in a meal, feeling full after eating only a small amount, and unintended weight loss. People with diabetes may have low blood sugar, because food does not reach the intestine on schedule. Many of these symptoms also occur with reflux, ulcers or medicine side effects, so a careful history matters. The chronic nausea guide and the bloating and gas guide describe other explanations.

Who is at risk

MedlinePlus says gastroparesis is a common complication of diabetes and can follow some surgeries. The encyclopedia lists long-standing diabetes or persistently very high blood sugar, partial removal of the stomach, systemic sclerosis and other autoimmune diseases, a post-viral illness and Parkinson disease as risk factors. Anticholinergic medicines and narcotic pain relievers can also slow stomach emptying. Reviewing every medicine you take, including over-the-counter ones, is part of a visit. The high blood sugar symptoms guide explains how glucose is monitored.

How it is diagnosed

MedlinePlus lists an upper endoscopy to look inside the stomach and a gastric emptying study, which usually uses food labeled with a small amount of radioactive material. A wireless motility capsule, a breath test or an upper GI series are other options. Because the practice does not perform these studies, they are arranged by referral to gastroenterology or imaging. Blood work at the office can check blood sugar, electrolytes and related levels, and the basic metabolic panel page explains what is measured.

Meals and blood sugar

The encyclopedia says people with diabetes should keep blood sugar well managed, which may improve symptoms. A diet of small, frequent meals and soft or pureed foods may relieve symptoms. Foods that are hard to break down can stay in the stomach longer, so plans are tailored to what you tolerate. The living with diabetes page describes how routine visits track blood sugar. Do not change insulin or other diabetes medicine on your own because meals have changed. Call the office first.

Medicines and procedures

According to MedlinePlus, treatment can include medicines that help the stomach empty, anti-nausea medicines and other drugs, with some used only short term. The encyclopedia notes that medicines often give only temporary benefit or cause side effects with long-term use. Electrical stimulation of the stomach, a muscle-cutting procedure at the stomach outlet, surgery and, for malnutrition, a feeding tube are other options. These are decided by a gastroenterologist or surgeon after referral, not at a primary care visit.

Complications and warning signs

The encyclopedia lists dehydration, electrolyte imbalances and malnutrition as possible complications, and serious problems in people with diabetes whose blood sugar stays poorly controlled. It advises contacting your provider if symptoms persist or new symptoms develop. Go to the emergency room for severe belly pain, vomiting that will not stop, vomiting blood, black stools, fainting, or confusion. The stomach flu and dehydration guide explains signs of dehydration.

Sources

• MedlinePlus: Gastroparesis (encyclopedia)