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Question:

From Toms River, New Jersey, USA:

Since a little before his diagnosis 1 year ago with Type 1 Diabetes, my son (age 10) has complained of severe stomachaches frequently. Our doctor knows of no reason this should be happening, but I heard of a study of diabetic gastroparesis, and the symptoms sound similar. What is diabetic gastroparesis and what can be done about it?

Answer:

This is a fairly common story and the long term outlook is very reassuring. There are three common explanations for the pain which may act individually or concurrently:

  1. In the early stages of diabetes including the weeks before there is an actual need for supplementary insulin there is a disorder of lipid metabolism which leads to a mild distension of the liver capsule and to some abdominal tenderness. In the old days extreme examples of this were called Mauriac Syndrome.

  2. In order to meet the kidney's needs to excrete excessive blood sugar the rest of the body may become dehydrated and this in turn will cause constipation and occasionally abdominal discomfort.

  3. During periods of stress many children, perhaps girls more frequently than boys, will complain of abdominal pain. In Britain this used to be known as Apley's Syndrome after a very nice paediatrician who wrote a small book on the subject and lived like Jane Austen in Bath.

    French researchers also have recently reported an uncommon association between Type 1 Diabetes, duodenal ulcer, the prescence of Helicobacter Pylori, abdominal pain and antibodies to the parietal cells of the stomach. The symptoms may appear before clinical diabetes is apparent. The observations are of interest because of the potential for antibiotic treatment.

From what I have said you will, I hope, have gathered that abdominal pain most often is a problem in the weeks before clinical diagnosis and in the period before effective control is established. There are of course other reasons for abdominal pain which may have to be invoked by your son's doctor if the symptoms do not clear.

Gastroparesis is a term that refers to delayed emptying of the stomach as a component of autonomic neuropathy, a complication of long-term poorly controlled diabetes, and is not something to which your son is presently vulnerable.

DO'B

Original posting 22 Apr 1998
Posted to Complications and Research: Causes and Prevention

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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