Once diagnosed, the treatment for diabetes-related gastroparesis is to optimise blood glucose levels and relieve symptoms.
It is important to note that in most cases treatment does not cure gastroparesis; it is usually a chronic condition. Treatment helps you manage the condition so that you can be as healthy and comfortable as possible.
Insulin for blood glucose control in people with diabetes
If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose levels, you may be advised to:
- take insulin more often
- take your insulin after you eat instead of before
- check your blood glucose levels frequently after you eat.
Your doctor and diabetes care team will give you specific advice based on your symptoms.
Treatments
Medication
Several drugs are used to treat gastroparesis. Your doctor and diabetes care team may try different drugs or combinations of drugs to find the most effective treatment.
Dietary treatments
Changing your eating habits may help control gastroparesis. Your dietitian will be able to give specific advice depending on your symptoms and may take several approaches to help manage your symptoms. This may consist of:
- Reducing your meal portions but eating more frequently
- Changing the consistency of your meals to more liquid or semi-solid consistency
- Reducing your fat intake as foods high in fat take longer to leave your stomach. If you are underweight fat contained in drinks eg supplement drinks may be better tolerated
- Reducing your fibre intake. This may go against advice you have previously been given. It is still important to have five portions of fruit and vegetables a day. However, puréed fruit, tinned fruit, peeled fruit may be better tolerated than fresh fruit
- Taking milk-based supplement drinks (these are often well-tolerated and useful if you have a poor dietary intake)
- Receiving nutrients through a tube which is inserted through the nose into the stomach or the small intestine. Special liquid food is used for this and is usually a temporary measure until symptoms improve
- Chewing your food well. This helps reduce the work of the stomach.
Surgical treatment
In very severe cases, surgical intervention may be needed to manage the symptoms of gastroparesis. This could include:
Feeding tube
A tube called a jejunostomy tube is inserted through the skin on the abdomen into the small intestine. This allows nutrients to be delivered directly into the small intestine, bypassing the stomach altogether. A special liquid food is used with this tube. A jejunostomy tube can be temporary and is used only if necessary when gastroparesis is severe.
Parenteral nutrition
Parenteral nutrition is when nutrients are directly delivered into the bloodstream, bypassing the digestive system. A thin tube called a catheter is inserted in a chest vein, leaving an opening to it outside the skin. A fluid containing nutrients is used which enters the blood stream through the vein.
This approach is an alternative to the jejunostomy tube (see ‘Feeding tube’ above) and is usually a temporary method. Parenteral nutrition is used only when gastroparesis is severe and is not helped by other methods.
Enterra therapy
Enterra therapy is an electronic device that is surgically inserted in the upper or mid abdomen region. This device uses mild electrical impulses to stimulate the stomach. This electrical stimulation may help to control the symptoms of nausea and vomiting associated with gastroparesis.
It is important to remember that none of these treatments are cures, but may be beneficial to relieve symptoms in people with gastroparesis. For further information please contact your diabetes care team.
Reviewed: April 2011
Next review: October 2012