Monday, 20 June 2016

Gastroparesis: An Autonomic Neuropathy Stomach Problem

Today's post from (see link below) looks at a specific symptom of autonomic neuropathy (nerve damage where the involuntary functions of the body are affected) that many neuropathy patients may suffer from but have no idea what it is and why it happens. It's called Gastroparesis and basically means that, due to nerve damage in the digestive system, food either stays too long in the stomach, or is not properly digested, leading to a whole raft of problems. One of the problems is that the tests for this are not pleasant, some might say 'invasive' and I would hazard a guess that most doctors won't take the trouble to carry them out because there are so many other possible causes of the symptoms that first come to mind. Read this short article and if you think you may fall into this category, be as persuasive as you can in getting yourself tested. Autonomic neuropathy is one of the worst forms of nerve damage to diagnose because it can affect so many bodily functions at the same time but that doesn't mean that it shouldn't be taken seriously.

Posted by Dr. Leonel Porta

Autonomic Neuropathy is one of the most common types of Neuropathy in diabetics. As the name implies, the autonomic nervous system is responsible for monitoring the functioning of the organs that act largely unconsciously and regulates bodily functions such as the heart rate, digestion, and respiratory rate.

When stomach function is impaired due to this nervous complication in diabetes, Gastroparesis (a condition in which your stomach cannot empty itself of food in a normal fashion) occurs. Today, we will focus on how to know if you have Gastroparesis and which tests will help the doctor diagnose this diabetic complication.

In DiabeTV we’ve talked about Gastroparesis and its complications, however, it is important to remember that Gastroparesis is a condition that consists of a delayed gastric emptying, that is, the stomach takes too long to empty its contents. What causes this? It’s caused by a damage to the vagus nerve, which controls the movement of food through the digestive system.

When a diabetic patient has complications such as Autonomic Neuropathy which are affecting the vagus nerve, the muscles of the stomach and intestines do not work properly, so that the movement of food is stopped or delayed. Remember, that when blood glucose levels remain raised for a prolonged time, damage occurs to the blood vessels that carry oxygen and nutrients to the nerves. Also, chemical changes can occur within nerves which alter their structure and function.

Some of the many symptoms that give indications of Gastroparesis, are nausea, vomiting of undigested food, poor appetite, weight loss, premature feeling of fullness when eating, bloating, heartburn, gastroesophageal reflux, and stomach spasms.

The tests that the doctor carry out to diagnose Gastroparesis are varied and depend on the severity of symptoms and conditions of the patients. These include:

Barium X-Rays: This test consists of an X-ray done after drinking a substance (barium) that allows the anatomy of the small intestine to be hightlighted and outlined. The presence of a blockage in any part of the small intestine will result in the accumulation of the barium solution which shows the gastric delayed emptying.

Gastric Emptying Scan: this is a nuclear medical test that shows whether the solid and liquid foods remain for too long in the stomach caused by a lowered emptying rate. The patient ingests a radiolabeled test meal food and by using a scanning technique the rate of gastric emptying is measured.

Gastric manometry:
This is a test to measure the electrical and muscular activity of the stomach during the digestive process. For this test, an endoscope is inserted through the mouth into the stomach. This provides information about the strength and frequency with which the stomach muscles contract under fasting or feeding conditions.

Upper Gastrointestinal Endoscopy:
this examination allows an screening of several causes Gastroparesis which appear as symptoms. Under an anesthesia a thin flexible probe is introduced via the mouth into the stomach. The endoscope allows an inspection of the upper gastrointestinal tract, looking for possible ulcers, swelling, tumors, hernias, or other abnormalities. If necessary, samples for biopsies may be taken.

Like the upper endoscopy, an ultrasound or a blood test will allow your doctor to rule out other possible causes of delay in gastric emptying, different from Autonomic Neuropathy.

Treatments for Gastroparesis include the use of insulin, oral medications, changes in the diet, and modifying eating schedule. In more severe cases, feeding tubes orally or intravenously insertes can be used. Gastroparesis associated with diabetes is an entirely preventable complication. The priority of all diabetic patients should always be to control their blood glucose levels. Only then they will avoid unnecessary complications and ensure their own welfare.

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