redbarronsnoopy
10-11-2006, 04:08 AM
Hi,
I'm writing simply to help guide other type 1 diabetics on these boards worried about problems they may encounter with the disease from time to time. I know I often have had questions that were never addressed correctly by my doctors directly, or even in books, so I'm writing from my own experiences to hopefully help a few others with questions/concerns they may have, pending their problems match closely with my own.
In this posting, I wanted to address gastroparesis versus IBS.
Every type 1 diabetic is terrified of developing Gastroparesis at one point (I know I was after I learned of the disease several years ago after reading Richard Bernsteins "The Diabeties Solution"). On and off again, I had had many of the problems he described and others describe as being associated with the disease.
Several months ago, after having the type 1 diabeties for almost 15 years, I started to develop constant burning in my stomach for hours after meals, constant belching, fullness, erratic blood sugars, and diarrhea. I was convinced I had developed or was developing mild to severe gastroparesis. I read post after post on the subject, and the 1 thing I did not experience was nausea.
I went to my doctor several times. He was convinced I did NOT have gastroparesis. I had a stomach emptying test done AND an upper and lower endoscopy as well as a full CT scan of my abdomen. No irregularities, my upper and lower endoscopys were negative, and my emptying study showed my digestion was actually far too RAPID...not slow (as gastroparesis is the result of damage to the vagus nerve which stimulates contraction of the stomach walls and hence digestion). Basically, after the emptying study, it was shown I had the OPPOSITE of gastroparesis....I had what my doctor referred to as a "spastic colon".
Now here's the interesting part for anyone out there terrified they have gastroparesis. Apparently, its FAR overdiagnosed. Turns out, according to my doctor (who is a co-founder for the #1 diabeties research lab in the state) it is far more common for diabetics to suffer problems with IBS and spastic colon. How?...simple. STRESS. We're under constant stress. People get vacations all the time...there is NO escape from insulin dependent diabeties. It's with you ALWAYS! THat coupled with the everyday stresses of life and we're definitely prone to stomach difficulties due to lowered levels of seratonin (produced in majority quantity in the intestines!)
Even more interesting...spastic colon can cause ALL of the symptoms of gastroparesis (minus severe CHRONIC nausea and vomiting). It can EVEN cause erratic blood sugars from foods being rapidly emptied into the small intestine..having been only partially digested..only to have them break down and digest hours later. This can lead to other symptoms of gastroapresis...including the presence of H-pylori in the small intestine and irritation around the esophaegal opening (from spastic stomach contractions which can cause food to re-enter the stomach and cause the stomach to over-compensate with large amounts of acidic digestive enzymes).
And guess what? FAT affects this too. It takes longer to break down in the small intestine. So, JUST like gastroparesis, IBS and spastic colon will flare up considerably when you eat high fat meals...even including the late, late jumps in post-prandial blood sugars to match.
I didn't believe my doctor, but he convinced me to try a medicine called Clidinium. It's an old medication for ulcer sufferers and is used in the treatment for IBS as well. I tried it for a week and NOTHING. Then, strangely, the second week, I started to feel better...a lot better. I had been taking the medication the first week with regualr before meal doses of Pepto-Bismol. I had been taking the Pepto to treat an H-pylori infection in my small intestine. My treatment ended after the first week and the h-pylori was gone. Turns out you're NEVER suposed to take Clidinium with antacids as they inhibit its effects!!
So, week 2...no Pepto...still on the Clidinium..I'm feeling better.
Well, it's week 3 now and I feel like a MILLION BUCKS. 8 months of pain, erratic blood sugars, constant abdominal discomfort and fullness....and having lost 60 pounds because of it later!
My blood sugars are PERFECT again. 80's to 120's all the time. No more strange lows in the 30's to 60's 1hr to 2 hr's afte rmeals, and I get lows ONLY when expected and my digestion has smoothed out perfectly.
Also, I no longer have the jumps in blood sugars that constantly resulted in post-prandial 1-2 hour spike's of 250-300 I have been living with for several years...that was before my stomach totally went bonkers 8 months ago and I started getting constant after meal lows as explained above.
How is this dualistic effect possible???simple...The Clidimium EVENS OUT my digestion and makes for a more even and predictable blood sugar pattern. MY digestion is no longer "spastic" (i.e....super fast stomach emptying and quick to absorb in the small intestine= BS 250-300...or super fast emptying but slow small-intestine absorbtion= BS 30-60).
I will say 1 more thing. I have an extememlly active job and am on the pump. I use Lispro fast-acting insuln and SO....I have had to change the way I bolus on the pump. I use square wave boluses ANYTIME my blood sugars are below 120 and/or I am going to be running around on my feet all day.
I know several other diabetics on the pump who are terrified they have gastroparesis as they constantly get LOW 1-2 hours after they eat. I've learned that this is normal with Lispro and the this particular insulin works BEST with a pump and delivered using a Square or dual-wave style bolus (especially for active people with a good circulation).
I even went back and reviewed blood sugar logs from BEFORE I was on Lispro insulin (back when I was on regular 2 hr peak insulin). I had problems with lows shortly after meals and I'd only been a diabetic for 4 years, so gastroparesis was ans still is very, very unlikely.
I have written this **** simply as an informational tool anyone worried about gastroparesis. I was convinced I had it, and it looks now like my doctor was right all along.
PS...I'm putting weight back on NO prob, my anxiety levels are way down, and my stomach feels GREAT all day. I also sleep like a baby. I DO get naseous when I don't eat for a long period of time (the medication) or when I get low blood sugars on an empty stomach). WHO KNEW that RAPID stomach emptying due to a spastic colon (aka IBS) could cause the same symptoms as a MUCH more serious OPPOSITE acting illness like gastroparesis??
Frankly, I'm relieved and a bit stunned.
Thre are a FEW things tha tled my doctor to believe I did NOT have gastroparesis. #1...the absence of nausea, #2, I did NOT have early satiety....I could eat a regular, decent sized meal no prob...(but the larger the meal, the more discomfort I tended to have and for longer periods of time), #3...my H-H study was fine and I had a normal resting heart rate (both suggestiing a properly functioning vagus nerve), #4...no constipation...ONLY diarrhea and especially after breakfast or coffee where I would experiece episodes of "dumping", #5...although i in NO WAY felt it...he thought I apeared stressed out, #6...my glycohemoglobin's for the last 10 years ranged from 6.1 to 6.8, averaging a 6.5. (although a normal A1C is in the 4 to 6 range), these A1C's were as close to perfect as he'd seen with any of his patients.
A final note, but I have made a life decision to go to the "Bernstein Diet" as excercised by 90+ year old type 1 diabetic (since the age of 12) Richard Bernstein. With this diet, a person can and will run an A1C of 4.3 to 4.8. Even insurance company's are unable to tell when reviewing medical charts if you are diabetic.
The diet consists of an ULTRA low-carb way of life utilizing dynamic approaches in nutrition and protein consumption for slow, even food absorbstion, and hence nearly un-changing blood sugars at meal times.
If you don't have these books and are a diabetic I STRONGLY recommend you read them. They are "The Diabeties Solution" (revised and updated) and The Diabeties Meal Planner (Both by Richard Bernstein).
Reading about complications such as gastroparesis in Bernstein's books (and the fact that those complications are being proven to be related to high post-prandial, or continuous high blood sugars) was enough to convert me to the system. Amazingly, if one follows Bernsteins system (and YES...he treats diabetics with gastroparaesis as well) one can actually begin to heal long-term nerve damage..reversing vagus neerve damage and the dreaded after-thought...gastroparesis. He has treated literally tousands of diabetics and has some of the best, practical advice I've ever read on treating the disease.
I've started with protein based dinners to ease in, and have never felt better...especially after dinner. Next, I am trying breakfast and dinner...and eventually...I'll go to it at lunch.
Good luck to all and I hope I helped shed LITTLE light to 2 very mis-understood and diagnosed diabetic complications.
8 months of chronic pain and, hence, research tends to make one well informed on their condition.
I'm writing simply to help guide other type 1 diabetics on these boards worried about problems they may encounter with the disease from time to time. I know I often have had questions that were never addressed correctly by my doctors directly, or even in books, so I'm writing from my own experiences to hopefully help a few others with questions/concerns they may have, pending their problems match closely with my own.
In this posting, I wanted to address gastroparesis versus IBS.
Every type 1 diabetic is terrified of developing Gastroparesis at one point (I know I was after I learned of the disease several years ago after reading Richard Bernsteins "The Diabeties Solution"). On and off again, I had had many of the problems he described and others describe as being associated with the disease.
Several months ago, after having the type 1 diabeties for almost 15 years, I started to develop constant burning in my stomach for hours after meals, constant belching, fullness, erratic blood sugars, and diarrhea. I was convinced I had developed or was developing mild to severe gastroparesis. I read post after post on the subject, and the 1 thing I did not experience was nausea.
I went to my doctor several times. He was convinced I did NOT have gastroparesis. I had a stomach emptying test done AND an upper and lower endoscopy as well as a full CT scan of my abdomen. No irregularities, my upper and lower endoscopys were negative, and my emptying study showed my digestion was actually far too RAPID...not slow (as gastroparesis is the result of damage to the vagus nerve which stimulates contraction of the stomach walls and hence digestion). Basically, after the emptying study, it was shown I had the OPPOSITE of gastroparesis....I had what my doctor referred to as a "spastic colon".
Now here's the interesting part for anyone out there terrified they have gastroparesis. Apparently, its FAR overdiagnosed. Turns out, according to my doctor (who is a co-founder for the #1 diabeties research lab in the state) it is far more common for diabetics to suffer problems with IBS and spastic colon. How?...simple. STRESS. We're under constant stress. People get vacations all the time...there is NO escape from insulin dependent diabeties. It's with you ALWAYS! THat coupled with the everyday stresses of life and we're definitely prone to stomach difficulties due to lowered levels of seratonin (produced in majority quantity in the intestines!)
Even more interesting...spastic colon can cause ALL of the symptoms of gastroparesis (minus severe CHRONIC nausea and vomiting). It can EVEN cause erratic blood sugars from foods being rapidly emptied into the small intestine..having been only partially digested..only to have them break down and digest hours later. This can lead to other symptoms of gastroapresis...including the presence of H-pylori in the small intestine and irritation around the esophaegal opening (from spastic stomach contractions which can cause food to re-enter the stomach and cause the stomach to over-compensate with large amounts of acidic digestive enzymes).
And guess what? FAT affects this too. It takes longer to break down in the small intestine. So, JUST like gastroparesis, IBS and spastic colon will flare up considerably when you eat high fat meals...even including the late, late jumps in post-prandial blood sugars to match.
I didn't believe my doctor, but he convinced me to try a medicine called Clidinium. It's an old medication for ulcer sufferers and is used in the treatment for IBS as well. I tried it for a week and NOTHING. Then, strangely, the second week, I started to feel better...a lot better. I had been taking the medication the first week with regualr before meal doses of Pepto-Bismol. I had been taking the Pepto to treat an H-pylori infection in my small intestine. My treatment ended after the first week and the h-pylori was gone. Turns out you're NEVER suposed to take Clidinium with antacids as they inhibit its effects!!
So, week 2...no Pepto...still on the Clidinium..I'm feeling better.
Well, it's week 3 now and I feel like a MILLION BUCKS. 8 months of pain, erratic blood sugars, constant abdominal discomfort and fullness....and having lost 60 pounds because of it later!
My blood sugars are PERFECT again. 80's to 120's all the time. No more strange lows in the 30's to 60's 1hr to 2 hr's afte rmeals, and I get lows ONLY when expected and my digestion has smoothed out perfectly.
Also, I no longer have the jumps in blood sugars that constantly resulted in post-prandial 1-2 hour spike's of 250-300 I have been living with for several years...that was before my stomach totally went bonkers 8 months ago and I started getting constant after meal lows as explained above.
How is this dualistic effect possible???simple...The Clidimium EVENS OUT my digestion and makes for a more even and predictable blood sugar pattern. MY digestion is no longer "spastic" (i.e....super fast stomach emptying and quick to absorb in the small intestine= BS 250-300...or super fast emptying but slow small-intestine absorbtion= BS 30-60).
I will say 1 more thing. I have an extememlly active job and am on the pump. I use Lispro fast-acting insuln and SO....I have had to change the way I bolus on the pump. I use square wave boluses ANYTIME my blood sugars are below 120 and/or I am going to be running around on my feet all day.
I know several other diabetics on the pump who are terrified they have gastroparesis as they constantly get LOW 1-2 hours after they eat. I've learned that this is normal with Lispro and the this particular insulin works BEST with a pump and delivered using a Square or dual-wave style bolus (especially for active people with a good circulation).
I even went back and reviewed blood sugar logs from BEFORE I was on Lispro insulin (back when I was on regular 2 hr peak insulin). I had problems with lows shortly after meals and I'd only been a diabetic for 4 years, so gastroparesis was ans still is very, very unlikely.
I have written this **** simply as an informational tool anyone worried about gastroparesis. I was convinced I had it, and it looks now like my doctor was right all along.
PS...I'm putting weight back on NO prob, my anxiety levels are way down, and my stomach feels GREAT all day. I also sleep like a baby. I DO get naseous when I don't eat for a long period of time (the medication) or when I get low blood sugars on an empty stomach). WHO KNEW that RAPID stomach emptying due to a spastic colon (aka IBS) could cause the same symptoms as a MUCH more serious OPPOSITE acting illness like gastroparesis??
Frankly, I'm relieved and a bit stunned.
Thre are a FEW things tha tled my doctor to believe I did NOT have gastroparesis. #1...the absence of nausea, #2, I did NOT have early satiety....I could eat a regular, decent sized meal no prob...(but the larger the meal, the more discomfort I tended to have and for longer periods of time), #3...my H-H study was fine and I had a normal resting heart rate (both suggestiing a properly functioning vagus nerve), #4...no constipation...ONLY diarrhea and especially after breakfast or coffee where I would experiece episodes of "dumping", #5...although i in NO WAY felt it...he thought I apeared stressed out, #6...my glycohemoglobin's for the last 10 years ranged from 6.1 to 6.8, averaging a 6.5. (although a normal A1C is in the 4 to 6 range), these A1C's were as close to perfect as he'd seen with any of his patients.
A final note, but I have made a life decision to go to the "Bernstein Diet" as excercised by 90+ year old type 1 diabetic (since the age of 12) Richard Bernstein. With this diet, a person can and will run an A1C of 4.3 to 4.8. Even insurance company's are unable to tell when reviewing medical charts if you are diabetic.
The diet consists of an ULTRA low-carb way of life utilizing dynamic approaches in nutrition and protein consumption for slow, even food absorbstion, and hence nearly un-changing blood sugars at meal times.
If you don't have these books and are a diabetic I STRONGLY recommend you read them. They are "The Diabeties Solution" (revised and updated) and The Diabeties Meal Planner (Both by Richard Bernstein).
Reading about complications such as gastroparesis in Bernstein's books (and the fact that those complications are being proven to be related to high post-prandial, or continuous high blood sugars) was enough to convert me to the system. Amazingly, if one follows Bernsteins system (and YES...he treats diabetics with gastroparaesis as well) one can actually begin to heal long-term nerve damage..reversing vagus neerve damage and the dreaded after-thought...gastroparesis. He has treated literally tousands of diabetics and has some of the best, practical advice I've ever read on treating the disease.
I've started with protein based dinners to ease in, and have never felt better...especially after dinner. Next, I am trying breakfast and dinner...and eventually...I'll go to it at lunch.
Good luck to all and I hope I helped shed LITTLE light to 2 very mis-understood and diagnosed diabetic complications.
8 months of chronic pain and, hence, research tends to make one well informed on their condition.