Treatment of Autonomic Neuropathy in Gastroparesis

Autonomic neuropathy can directly affect gastrointestinal function. When it presents alongside gastroparesis, careful clinical evaluation is needed — particularly when erratic glycemic control or unexplained upper GI symptoms are present.

Clinical scenario Gastroparesis should be suspected in individuals with erratic glycemic management or with upper gastrointestinal symptoms without another identified cause. This protocol addresses autonomic neuropathy specifically in the context of this gastrointestinal complication.

First-line approach (partial overview) Management centres on a specific dietary pattern to relieve symptoms, combined with a structured review of concurrent medications known to impair gastrointestinal motility. Full protocol — including which agents to consider withdrawing and the complete dietary guidance — is available via the link below.

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References

Gastroparesis should be suspected in individuals with erratic glycemic management or with upper gastrointestinal symptoms without another identified cause.

A small-particle eating pattern may provide some symptom relief.

Withdrawing drugs with adverse effects on gastrointestinal motility, including opioids, anticholinergics, TCAs, GLP-1 RAs, and pramlintide, may also improve intestinal motility.

DOI: 10.2337/dc26-S012

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