Complications with gastroparesis

Complications & More
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I have diabetic gastroparesis. i take Domperidone for it (i get it from Canada b/c its not available/FDA approved in the USA)

for the most part it works without a glitch. my BGs are excellent; my food digests normally now.
however, i get sporadic flare-ups and get bacterial infections in my stomach. it is very very uncomfortable. i get nauseated, seriously bloated, and get very toxic gas, and my stool is abnormal. (hope that isnt too TMI )

last night i was so uncomfortable, i paged my GI doc but he wouldnt perscibe antibiotics (which always work perfectly) which he knows has worked for me in the past. but, he wouldnt perscribe until i came in to his office (all the way into the city, ugh); but i just saw him 2 months ago; what could seeing him in person that could possibly help? i had already had an endoscope, a gastric emptying test, etc. in the past he has put me on a 10 day round of erithromyacin., and it works like a charm within two days, whats his deal besides wanting more money for an office visit. UGH.

anyhow, i just wanted to have some FUD info on dealing with this disorder. i went on the “search” site and couldnt find anything on this subject. just want to know what others do when these flare-ups happen.so this morning at 8:30 my husband drove me to an Urgent Care Office. the doctor was amazing, she was D educated and commented on my pump. she knew immediately what i was talking about when we went over my symptoms and she called the antibiotic right in to the pharmacy. it was ready in 3 minutes.
thank goodness.

so, SOS on the subject! thanks in advance, DM

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@daisymae, Samson doesn’t have gastroparesis (that we know of) but reading about it it certainly seems like a major frustration and pain. Either way, I’m very happy that you lucked out in Urgent Care and were able to get relief without the same level of hassle as the GI doc would require!

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DM, sorry you aren’t feeling well, we all know how much that sucks, especially on top of diabetes management. uugh.

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Gosh, @daisymae, so sorry this happened to you :frowning: I can’t believe your doc wouldn’t call in it :frowning:

I was unaware that the definition of gastroparesis had recently changed (2013):

I know this is not much help to you, but I recently read this fairly recent (2009) article on diagnosis and treatment of gastroparesis that I thought you might be interested in (you may have read it already):

RareDiseases.org also has an interesting in-depth write-up:

https://rarediseases.org/rare-diseases/gastroparesis/

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Needing to Revisit this Topic:

So its been 5 years since I have brought up this topic. And I bring it up bc it has become VERY pertinent to me lately. My Gastrointerologist significantly reduced my Domperidone from 20mg 4 times a day down to 10mg 3 times a day, then 2 10mg twice a day. He felt that "less is more".( My former symptoms had disappeared…but I say, “if the clock ain’t broke, dont fix it.” And perhaps the symptoms had disappeared bc I was taking the right medication and it was working) Well it took about a year, but my Gastroparesis symptoms returned, and returned BIG time. The nausea, the bloating, the alternating constipation/diarreah, the constant feeling of fullness despite skipping meals (and then the weight loss that comes with lack of calories).

I have discussed this with both my Endocrinologist and my Gastroenterologist. I thought all those symptoms were related to the medication I have been taking for pain since my spinal surgery, which could have contributed to this flare up, but I dont know and no one else seems to either.

HOW DOES THIS RELATE TO DIABETES ?

I started having trouble with stable blood sugars. I was constantly crashing about 2- 2 1/2 hours after eating. It was as if my insulin was not matching the absorption of my meals. I tried basal testing, but my basals were set just fine. So two days ago I changed my ICRs to see if giving myself less insulin at mealtime would keep me from crashing. I moderately changed the ICRs; I didnt want to do anything too dramatic, bc I wanted to see if there was any difference at all, even if it were just a little improvement.

Well for the past 2 days, its been working. I went back to the original dosage of the Domperidone as well. Now I’m just waiting to see if there is a fluke, or if I have found the solution.

Does anyone out there in FUD-Land experience this in any way? Does anyone relate to the issues of Gastroparesis?

I welcome ALL thoughts, experiences, comments, suggestions.

And btw, I also take a medication called Motegrity which causes the intestinal track to spasm and to speed mobility of food ingested.

Thanks in advance,

DM

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Can’t offer any advice, but have struggled for a few months with increased symptoms. The last several years my symptoms were pretty mild, but they kicked back up for some reason. Very frustrating.

I also use Domperidone. I haven’t tried motegrity, but will keep that in mind.

Hang in there and keep fighting the good fight.

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Thanks for your sharing and support. I dont understand the reason behind the flare-ups either. I am also wondering why I was doing so well for so long with such a low dosage of the Domperidone, and then BOOM, I needed to increase it again. Also, this time round, I am taking a medication called XIFAXAN, which is some very powerful anti-bacterial for the stomach, intestines, etc. You take 3 pills a day for 2 weeks, and the symptoms are relieved (somewhat, but not entirely).

The XIFAXAN definately, though, works better than the Erithromyacin.

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Starting all over again with basal testing:

My BGs have been all over the place. Low, high, but rarely in TR for any period of time. I tried changing my ICRs and my ISF (my former one was definately delivering too much correction insulin; that was the easiest part of the equation to change.)

Breakfast has been the easiest with basal testing bc I havent eaten anything over the night, and I am bolusing for breakfast without any IOB. So, slowly, Ive been making changes in that. But Ive been doing it very modestly one day at a time. I am needing more and more Bolus Insulin each morning; so, I havent found my sweet spot yet. For example, I can bolus when my sugars are 80, and within an hour, I will have spiked up into the 160s. Today, despite all the IOB, I did a correction bolus. it worked very well, so that was a relief.

I skipped lunch today to keep my eye on my sugars without any IOB and watching how my BGs rise or fall (or hopefully stay in TR) Currently, my BG is 105. I was 80 after bfast, took 4gms glucose, but instead of going up, my BGs went down to 75 I took another 4gms, and now I am near where I had hoped to b.

The XIFAXAN is definately working, bc I have been able to go to the bathroom almost “normally”. God only knows if the Motegrity is working, and I increased that Domperidone but I am not certain if it has kicked in yet.

We’ll see how it goes.

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