Ask the Mayo Physician - Gastroparesis

ASK THE MAYO PHYSICIAN
	02.22.99

Current

Q

uestion &

A

nswer

Joe / Montana

A. Gastroparesis is a medical term for paralysis of the stomach. The muscles in the wall of the stomach normally contract in a rhythmic fashion to mix the food and digestive juices, and to propel its contents from the stomach into the small intestine. This muscular action is under the control of the autonomic (automatic) nervous system.

In people with diabetes, nerve damage (neuropathy) is one of the common complications. It most often involves the peripheral nerves that carry sensory messages and leads to pain or loss of sensation, particularly in the feet and legs (diabetic sensory neuropathy). Diabetic neuropathy may also damage the autonomic nerves that control the stomach and bowel, as well as the bladder and sexual function (diabetic autonomic neuropathy). In the case of gastroparesis, the stomach loses its coordinated muscular activity so that food is not emptied normally. This leads to stomach enlargement (distention) and may cause vomiting of food eaten a day or even days before. This problem may severely complicate the control of the diabetes because of the erratic absorption of nutrients, especially carbohydrates, in the diet. In turn, poor control of diabetes worsens the neuropathy. There are medications, such as metoclopromide and cisapride, that may help restore motility of the stomach to ease the problem.

Autonomic neuropathy of diabetes that involves the small and large intestine may cause either constipation or diarrhea, decreased absorption of fat from the diet (steatorrhea) and fecal incontinence, particularly in the night.

For more information

Peripheral neuropathy - Managing the pain, frustration Diabetes quiz - Are you at risk? Diabetes drug update - Oral medications for type 2 diabetes Interactive digestive tour