The primary treatment goal for gastroparesis related to diabetes is to regain control of blood glucose levels. Treatments include insulin, oral medications, changes in what and when you eat, and, in severe cases, feeding tubes and intravenous feeding.
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
If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to
- take insulin more often
- take your insulin after you eat instead of before
- check your blood glucose levels frequently after you eat and administer insulin whenever necessary
Your doctor will give you specific instructions based on your particular needs.
Medication for Gastroparesis
Several drugs are used to treat gastroparesis. Your doctor may try different drugs or combinations of drugs to find the most effective treatment.
- Metoclopramide (Reglan). This drug stimulates stomach muscle
contractions to help empty food. It also helps reduce nausea and vomiting.
Metoclopramide is taken 20 to 30 minutes before meals and at bedtime.
Side effects of this drug are fatigue, sleepiness, and sometimes depression, anxiety, and problems with physical movement.
- Erythromycin. This antibiotic also improves stomach emptying.
It works by increasing the contractions that move food through the stomach.
Side effects are nausea, vomiting, and abdominal cramps.
- Domperidone. The Food and Drug Administration is reviewing
domperidone, which has been used elsewhere in the world to treat gastroparesis. It is a promotility agent like metoclopramide. Domperidone
also helps with nausea.
- Other medications. Other medications may be used to treat symptoms and problems related to gastroparesis. For example, an antiemetic can help with nausea and vomiting. Antibiotics will clear up a bacterial
infection. If you have a bezoar, the doctor may use an endoscope to inject medication that will dissolve it.
