Gastroparesis or Dumping Syndrome??

[Auto E]

I have suffered for about 10 years with occasional nocturnal diarrhea and vomiting. The episodes have gotten more intense, to the point that my husband took me to the ER a few weeks ago. Of course they just gave me fluids and told me I had a GI bug.

[Rant begins here - skip if you prefer to not listen to major tantrums from posters..... ;-)
Before you suggest I find a doctor that will work with me, I will just be honest: I'm not really interested in seeing if doctors can help me other than when I bother them to order blood tests and prescribe CGMs! I have a nephrologist, a urologist, an endocrinologist, and a GP and none of them seem willing to work creatively with me (I don't blame them - they just don't have the time to be creative but I am a scientist so creative by trade, lol). I had to go through 4 doctors before I finally got a prescription for a CGM. I couldn't believe that they would turn me down since I was completely willing/understanding that I would pay out of pocket.
Not a single doctor has connected my "mysterious" chronic kidney disease with my blood sugar dysregulation. But I have my CGM now, and I have found websites that allow me to pay out of pocket for all my desired blood tests, so I'm going rogue on my own now!
End Rant.]

I only have prediabetes, but I am starting to wonder if my reactive hypoglycemia/big spikes after eating carb junk, has damaged my nerves and I may be suffering from gastroparesis and/or dumping syndrome.

These episodes always follow heavy meals, but not always carb meals. The worst episodes have been after:
**a double cheeseburger (homemade patties and a 20 g carb bun, so not "high-carb" meal) - toppings like guacamole, bacon, onion)
**double cheeseburger patties with NO bun (guacamole, bacon, onion)
**salmon filet baked in a lot of butter and saurkraut (so see! It's not just beef!)
**last night - 2 chicken drumsticks and a small piece of pepperoni pizza (yes an indulgence but I calculated it at 35 g carb so not crazy high)

So, my take-home at this point is that a meal with a lot of protein and fat is not digesting properly for me. Carbs don't seem to be the common thread.

I wear a CGM now and I can confirm that during last night's episode my blood sugar remained in the 90's throughout. In earlier episodes fingerpricks always showed similar results. Blood PRESSURE, on the other hand, has sometimes been shockingly low. My husband has helped me get some broth down to increase my salt. For a while we thought it was lack of electrolytes bringing on these episodes, but last night's meal had plenty of salt, and so did the salmon meal the episode prior to that.

Oh. Last clue. This ONLY happens in the middle of the night!!!! I'll go to sleep (sometimes already a teensy bit sick to my stomach) and then wake up a few hours later sick as a dog. I feel like this further supports a slow digestive process in which going to sleep allows everything to sit in my stomach more than if I stayed up and moving about. On the other hand, I tend to eat lightly earlier in the day, so the nighttime thing could be unrelated.

So. I feel like I've ruled out many things and I'm suspicious that my digestion is slower (or faster)? than normal due to nerve damage from blood sugar spikes over the years. I also have chronic kidney disease so I think I'm one of those people that can suffer organ damage at almost "normal" blood sugars.

I'm wondering if anyone has similar experiences such as mine? I'm feeling a bit sorry for myself (it's Thanksgiving in the US today and I'm nervous about whether I'll be OK).

Last, if there are other threads on this forum that discuss this topic, I'd love it if you could point me to them.

 

[Lamont D]

Glucose dumping is where a patient has little or no insulin response to a meal, the blood sugar level will rise very quickly, then within the next few hours depending on severity, the pancreas will respond and try and get rid of the glucose.
Many conditions occur because glucose dumping is caused by too much sugar and you have a quick movement into the duodenum. Or if it is late glucose dumping syndrome, this occurs after three to four hours after a meal.
This is called alimentary Hypoglycaemia.

Symptoms for both of these is vomiting, diarrhoea and other symptoms.

I have read about gastroperesis but don't know enough to comment!

 

[Auto E]

Glucose dumping is where a patient has little or no insulin response to a meal, the blood sugar level will rise very quickly, then within the next few hours depending on severity, the pancreas will respond and try and get rid of the glucose.
Many conditions occur because glucose dumping is caused by too much sugar and you have a quick movement into the duodenum. Or if it is late glucose dumping syndrome, this occurs after three to four hours after a meal.
This is called alimentary Hypoglycaemia.

Symptoms for both of these is vomiting, diarrhoea and other symptoms.

I have read about gastroperesis but don't know enough to comment!

From what I've read, gastric dumping (not glucose dumping) is caused anytime the food moves too rapidly into the intestine (as you mentioned). Although I could think that blood sugar spikes are what CAUSED the damage to the nerves controlling this, once the damage is done the "dumping" could theoretically occur in response to any large meal, whether it has carbs or not. So a T2D on a low-carb diet could still suffer from it.

 

[Alexandra100]

I only have prediabetes, but I am starting to wonder if my reactive hypoglycemia/big spikes after eating carb junk, has damaged my nerves and I may be suffering from gastroparesis

I can'r comment on gastric dumping as this is the first time I ever heard of it. (But I'll be checking it out.) I do believe I suffer from gastroparesis (GP). My highest A1c (that I know of) was 41 = 5.9%, which you will know counts as pre-diabetic in the US, but not in the UK where the cutoff is 42 = 6%. That was over 2 years ago. A few months of gradually reducing carbs brought my A1c down to 38 = 5.6% and there it has stalled. Cutting carbs to the bone has not reduced it any more.

I believe that diabetic complications do set in long before official diabetic bgs are reached. Sadly doctors are not in the business of making connections. For years I was asking why I, with an obsessively healthy Mediterranean style diet and a reasonable exercise habit, not smoking or drinking and for many years consuming little or no caffeine, should be suffering a cluster of serious health problems. I now know that raised bgs damage nerves. This includes the great vagus nerve. Why did I suffer from vagal AF and digestive problems? Because the vagus nerve controls both.

I don't think eating carbs leads to gastroparesis episodes, except indirectly by causing high bgs. Perhaps eating lots of protein and fat instead of carbs, known to delay digestion, leads to worse GP episodes? Since I began eating lower carb, my digestion has improved but it is by no means cured. Dr Bernstein says that GP can be cured by perfect bgs but it takes years. I will not be able to achieve perfect bgs but I do think that at least some of my health problems will gradually improve if I keep my bgs as low as I can.

It seems to me you are managing your bgs fantastically well. Nil desperandum! Dr B has proved that advanced kidney damage can be cured. Your digestive upsets sound horrid, but with early dinners and persistent low carbing, I do believe your symptoms will gradually abate.

Edited by Mod

 

[Brunneria]

Hi @Auto E

Have you tried taking digestive enzymes with your food? Different enzymes act on the fat, the protein and the carbs.

A couple of years ago I had a rather unpleasant gut upset, and my ability to digest, move through and eliminate (note the delicate word choices) was severely impaired for months.

By trial and error I discovered that fibre was causing a lot of the aggro, and I went carnivore. Worked like a charm, except that My guts had gone into such a decline that I needed some additional digestive enzymes for a couple of months while things slowly improved.

Obviously, I’m not suggesting that your situation is like mine in the cause, or the solution, but it may be worth shelling out for a tub of digestive enzyme tablets to see if they help you. I used the Solgar brand, but there are plenty of other companies producing them.

 

[DCUKMod]

I can'r comment on gastric dumping as this is the first time I ever heard of it. (But I'll be checking it out.) I do believe I suffer from gastroparesis (GP). My highest A1c (that I know of) was 41 = 5.9%, which you will know counts as pre-diabetic in the US, but not in the UK where the cutoff is 42 = 6%. That was over 2 years ago. A few months of gradually reducing carbs brought my A1c down to 38 = 5.6% and there it has stalled. Cutting carbs to the bone has not reduced it any more. My explanation for this is that while my carb management has improved, my insulin production is gradually reducing as in the LADA honeymoon period.

I believe that diabetic complications do set in long before official diabetic bgs are reached. Sadly doctors are not in the business of making connections. For years I was asking why I, with an obsessively healthy Mediterranean style diet and a reasonable exercise habit, not smoking or drinking and for many years consuming little or no caffeine, should be suffering a cluster of serious health problems. I now know that raised bgs damage nerves. This includes the great vagus nerve. Why did I suffer from vagal AF and digestive problems? Because the vagus nerve controls both.

I don't think eating carbs leads to gastroparesis episodes, except indirectly by causing high bgs. Perhaps eating lots of protein and fat instead of carbs, known to delay digestion, leads to worse GP episodes? Since I began eating lower carb, my digestion has improved but it is by no means cured. Dr Bernstein says that GP can be cured by perfect bgs but it takes years. I will not be able to achieve perfect bgs but I do think that at least some of my health problems will gradually improve if I keep my bgs as low as I can.

It seems to me you are managing your bgs fantastically well. Nil desperandum! Dr B has proved that advanced kidney damage can be cured. Your digestive upsets sound horrid, but with early dinners and persistent low carbing, I do believe your symptoms will gradually abate.

Alexandra - What tests have your medical team done to assess your insulin production?

 

[Alexandra100]

Alexandra - What tests have your medical team done to assess your insulin production?

None so far. I asked for a c-peptide test, but my GP checked the guidelines, which say this test should be used to find out if people are producing too much insulin. It doesn't actually say, the test should not be used to check for too little insulin production, but that is how she understood it. I am intending to ask her again soon.

 

[Lamont D]

From what I've read, gastric dumping (not glucose dumping) is caused anytime the food moves too rapidly into the intestine (as you mentioned). Although I could think that blood sugar spikes are what CAUSED the damage to the nerves controlling this, once the damage is done the "dumping" could theoretically occur in response to any large meal, whether it has carbs or not. So a T2D on a low-carb diet could still suffer from it.

You have too also consider inflammation as to the cause of the damage to the stomach/duodenum, if you have hiatus hernia, due to the constant vomiting will also have nerve damage.
There is something called the gut brain trigger, which has a huge effect, as does the bacteria, good or bad that is present in your stomach.

Hope you sort it out whatever the condition.

 

[Auto E]

Hi @Auto E

Have you tried taking digestive enzymes with your food? Different enzymes act on the fat, the protein and the carbs.

A couple of years ago I had a rather unpleasant gut upset, and my ability to digest, move through and eliminate (note the delicate word choices) was severely impaired for months.

By trial and error I discovered that fibre was causing a lot of the aggro, and I went carnivore. Worked like a charm, except that My guts had gone into such a decline that I needed some additional digestive enzymes for a couple of months while things slowly improved.

Obviously, I’m not suggesting that your situation is like mine in the cause, or the solution, but it may be worth shelling out for a tub of digestive enzyme tablets to see if they help you. I used the Solgar brand, but there are plenty of other companies producing them.

I will give this a try!

 

[Auto E]

I can'r comment on gastric dumping as this is the first time I ever heard of it. (But I'll be checking it out.) I do believe I suffer from gastroparesis (GP). My highest A1c (that I know of) was 41 = 5.9%, which you will know counts as pre-diabetic in the US, but not in the UK where the cutoff is 42 = 6%. That was over 2 years ago. A few months of gradually reducing carbs brought my A1c down to 38 = 5.6% and there it has stalled. Cutting carbs to the bone has not reduced it any more.

I believe that diabetic complications do set in long before official diabetic bgs are reached. Sadly doctors are not in the business of making connections. For years I was asking why I, with an obsessively healthy Mediterranean style diet and a reasonable exercise habit, not smoking or drinking and for many years consuming little or no caffeine, should be suffering a cluster of serious health problems. I now know that raised bgs damage nerves. This includes the great vagus nerve. Why did I suffer from vagal AF and digestive problems? Because the vagus nerve controls both.

I don't think eating carbs leads to gastroparesis episodes, except indirectly by causing high bgs. Perhaps eating lots of protein and fat instead of carbs, known to delay digestion, leads to worse GP episodes? Since I began eating lower carb, my digestion has improved but it is by no means cured. Dr Bernstein says that GP can be cured by perfect bgs but it takes years. I will not be able to achieve perfect bgs but I do think that at least some of my health problems will gradually improve if I keep my bgs as low as I can.

It seems to me you are managing your bgs fantastically well. Nil desperandum! Dr B has proved that advanced kidney damage can be cured. Your digestive upsets sound horrid, but with early dinners and persistent low carbing, I do believe your symptoms will gradually abate.

Edited by Mod

I am pulling out my Dr. B book again.
Thank you for this great feedback.