How to manage diabetic gastroparesis?

Q: My sister has diabetes and some of her complications include neuropathy and chronic renal failure. Recently she has been diagnosed with gastroparesis, which is making her very ill and she is vomiting constantly she gets severe pain in her stomach and has to be admitted to the hospital frequently. I am not sure what the treatment is because she can't take any medicines. She also has an under active thyroid. She needs medicines for her kidneys etc. but is constantly vomiting and throwing them up. Is there anything she should avoid to make things easier?

A:With the information that you have provided, it appears that diabetic gastroparesis is the main problem. However, I must say that in patients with bad diabetes and renal failure, if recurrent vomiting is a major problem, then one must exclude oral or oesophageal candida (fungal) infection. This can be best diagnosed by upper GI endoscopy. Endoscopy will also exclude other causes such as hiatus hernia, GE reflux, etc.So you need to treat the underlying cause for vomiting. If gastroparesis is the only problem, then you should try Prokinetic agents such as Domperidone, Itopride, or erythromycin. Your doctor can advise you regarding this.