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[IP] Gastroperesis Importent Background Information RATHER LONG

I note a lot of postings on stomach problems and gastroparesis tonight.
This is a copy of an email that I sent directly to a Pumper that was having
big problems.  I will change the original email some.  There are other
medications that can be used in helping alleviate the problems beside the
ones that I name.
(These comments probably do not relate to the young children that are having
stomach pain that seems to come with high BS levels.)

Dear XXXXX::              Aug. 21, '99
      The problem you have most likely will not get better by its self. The
history that you have given is very typical of gastroparesis.  I suspect
that most likely  you have been a diabetic for several years.  Your Vagus
nerve that supplies the stomach and gives the stomach its' orders is being
affected by diabetic neuritis. It is not giving your stomach the
instructions that it should in the proper sequence.
    It should send "orders" to start a serious of contractions starting at
the top of the stomach.The waves of contractions work there way down the
stomach to the bottom. These contractions push the food and the ACID down to
the bottom.  The last order to the stomach at the bottom should be for the
pyloric valve or sphincter to open and allow for some of the food and ACID
to be expressed into the duodenum to start its way down through intestines.
But in many cases like this the signal to the duodenum (or pylorus ) dose
not arrive at the correct sequence and the "Opening" dose not occur when it
should.  The food and acid are blocked in the stomach.
    The longer food is held in the stomach the more acid is secreted and
also the acid condition causes even more acid to be secreted.  The stomach
gets "burned by the acid"and becomes very tender.  The stopped up food
causes more blotting and discomfort.  When the food dose not get into the
intestine at the proper time,the rise in BS level delayed.  The insulin is
there  but the food is not.  This can cause low BS's when the food is
delayed. Eventually some of food gets into the intestines and starts to get
absorbed. The insulin action has preceded it . The two do not work together
as they should.  This causes "Erratic BS's" that  are hard to figure out.
In some people they will also experience GI irregularity and in very  bad
cases even frequently  vomiting.
 There is a stomach emptying test that usually demonstrates the
gastroparesis  problem fairly easily.

Bad news!  The Vagus nerve also supplies other important organs and all of
these can cause problems due to the same nerve damage.
If you have not seen one, you do need to check with a gastroenterologest. I
had to see THREE different ones before I found one that was able to work the
medications out for me.  There are at least 3 medications that can  help the
stomach to empty better and more regularly.  Acid secretion can be regulated
or blocked by at least two meds.  Prevacid is one of the acid blockers that
I am using.

One MD that works with a lot of people on pumps clams that with very  tight
control of the blood sugars that the stomach condition will improve.  In my
case I believe that my lower A1C levels are helping.  But I have also been
on a strong  antacid for almost 9 years.

Now I have given you a whole ear full and you may not have wanted to know
any of it.  I hope that you are already getting some proper treatment.  If
you feel like I would be interested to know how things work out for you.

The above may contain some simplifications  that someone may object to but
it is a fairly close explanati of  the problems that many of us are

Charles Soderstrom DDS   In Chico, CA     dx  IDDM  46 years and on pump for
the last 3.

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