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    When Diabetes Causes Stomach Problems

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    Diagnosis

    Your doctor will ask about your symptoms. He’ll also do a physical exam, and he may check your blood sugar. He might also suggest that you take some of these other tests:

    • Barium X-ray: You drink a liquid (barium), which coats your esophagus, stomach, and small intestine and shows up on X-rays. This test is also known as an upper GI (gastrointestinal) series or a barium swallow.
    • Barium beefsteak meal: You eat a meal with barium in it, and the doctor uses an X-ray to watch how long it takes you to digest the food. That tell your doctor how quickly your stomach empties.
    • Radioisotope gastric-emptying scan: You eat food that has a radioactive substance in it. Then you lie under a scanner that detects the radiation. If the scan shows that more than half of the meal is still in your stomach after 1.5 hours, you have gastroparesis.
    • Gastric manometry: Your doctor guides a thin tube through your mouth and into your stomach. It measures how quickly you digest food.
    • Wireless motility capsule: You swallow this tiny device with a meal. It measures the pressure, temperature, and pH of different parts of your gut.
    • Electrogastrography: During this test, you wear electrodes on your skin to measure electrical activity in your stomach.
    • Ultrasound: The doctor uses sound waves to show the inside of your body.
    • Upper endoscopy: Your doctor will pass a thin tube (called an endoscope) down your throat to view the lining of your stomach.
    • Stomach or small intestine biopsy: Your doctor may need to take a small sample of tissue to confirm the diagnosis.

    Treatment

    Although there is no cure, you can manage gastroparesis and its symptoms.

    Controlling your blood sugar helps. Ask your doctor if you should change when and how often you use insulin, and check your sugar levels more often.

    Also, talk with your doctor about whether you should stop or change medications that might worsen gastroparesis. These include antidepressants, high blood pressure drugs, and certain diabetes treatments.

    For some people with gastroparesis, these medications and procedures can help:

    • Domperidone (Motilium): This medication manages problems in your upper digestive system that are linked to gastroparesis. Side effects include headache.
    • Erythromycin: This antibiotic also causes your stomach to move food out. Side effects include diarrhea.
    • Metoclopramide (Reglan): You take this drug before you eat. It causes your stomach muscles to move, which helps food leave your system. It may also prevent nausea and vomiting. The drug can cause diarrhea.
    • Gastric electrical stimulation: This surgically implanted device sends out brief, low-energy impulses to your stomach to help against nausea and vomiting.
    • Feeding tube placement: In extreme cases, a surgeon inserts a tube through the abdominal wall directly into your small intestine. You're fed specially made liquid meals through the tube.
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