I was diagnosed about 20 years ago with gastroparesis.
Although diabetes is the main cause of gastroparesis it is NOT the only cause of it. It can also be caused by injury from digestive tract surgery or some other sickness, such as Parkinson’s disease or Multiple Sclerosis. If a ‘reason’ cannot be identified, it’s called idiopathic gastroparesis.
Unfortunately, sir, what you consider “relatively well controlled” MAY not be what medical professionals consider ‘well-controlled’. Raised blood sugar (glucose)levels are what cause damage to occur to the vagus nerve. It’s this damage that causes the gastroparesis, which simply means delayed or stopped emptying of the digestive tract.
I’m not sure what tests they use these days before diagnosing gastroparesis, but when I was tested I had to drink a barium ‘meal’ and have x-rays taken periodically over the course of several ours, which clearly showed that ‘food’ wasn’t passing from my stomach into my intestines at a regularly ‘normal’ rate. (Gastroparesis, by the way, means delayed or stopped emptying of the stomach, which can lead to nausea, acid reflux (acid regurgitation), which is a condition in which stomach contents flow back up into the esophagus. It can result in pain in the abdomen, over the area of the stomach, abdominal bloating/fullness, and/or lack of appetite.)
If you feel that the Motilium (Domperidone) isn’t having the desired effect, ask your gatroenterologist if s/he would consider Metoclopramide (Metoclopramide hydrochloride) as this helps by stimulating an increases in muscle contractions in the upper digestive tract (small intestine). This speeds up the rate at which the stomach empties into the intestines, and also helps with nausea/vomiting. (See https://www.drugs.com/metoclopramide.html for more information on this medication. I suggest you read it as there’s quite a bit of relevant information on there that MAY be pertinent to you.)
IF your gastroparesis is as a result of your diabetes, sir, it indicates that your long-term blood glucose control isn’t quite as good as you feel it has been. As it’s a form of neuropathy (nerve-ending damage), it MAY show that you are MORE LIKELY to develop other forms of neuropathy. The risk can be lowered by keeping tighter control of your blood glucose levels, but this is NOT saying that you will never develop other types of neuropathy. (The most common type of neuropathy experienced by tose suffering with diabetes is called diabetic peripheral neuropathy, which is ‘altered’ sensations to the extremities. i.e. your toes/feet/lower legs, and fingers/hands/forearms. The next most common type is called autonomic neuropathy, of which gastroparesis is considered one of these. This type can affect things such as blood pressure control, heart rate, bowel and bladder function, sexual function, temperature control, and the like. i.e. things that are normally taken care of ‘automatically’ by your body’s homeostasis, which means keeping things ‘in order’ or ‘in balance’.)
I’ve just done a quick search and found a very informative webpage on gastroparesis, sir, that you MAY like to read. It offeres information on causes, symptoms, tests and diagnosis, treatments, etc. (See https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis).
Both your diabetologist/endocrinologist and your gastroenterologist/gastrologist should be working together to ensure that you’re receiving the correct treatment AND things are made easier for you.
I wish you well, sir.
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P.S. Please don’t be offended, or alarmed, at the ‘x’s’. It’s merely a logo, of sorts, that I’ve used for some 40 years now.