Gastrointestinal complications of diabetes
Journal
Journal of Internal Medicine of Taiwan
Journal Volume
20
Journal Issue
5
Pages
409-416
Date Issued
2009
Author(s)
Abstract
Diabetic patients have higher prevalence of gastrointestinal symptoms. The main cause is gastrointestinal dysmotility associated with enteric autonomic neuropathy. Other gastrointestinal diseases or medications are also among the causes. Common gastrointestinal complications of diabetes include acid reflux, dysmotility, and Candida esophagitis in esophagus; gastroparesis in stomach; diarrhea, bacterial overgrowth, and celiac disease in intestine; constipation in colon; fecal incontinence in anus. Diagnosis of esophageal complication is not difficult. The treatment is the same as those for other common conditions. Diabetic gastroparesis is a diagnosis by exclusion and a delayed gastric emptying time on scintiscan. Patients with mild to moderate symptoms are often successfully treated with glycemic control, diet adjustment, and prokinetic agents. For severe disease, gastric electrical stimulation, gastrostomy for decompression and jejunostomy for feeding are other choices. Diabetic diarrhea, constipation, and fecal incontinence are also diagnosed by exclusion. In addition to glycemic control, the therapy is basically supportive and symptomatic. If celiac disease is suspected, gluten free diet is suggested. In the future, studies that focus the mechanism of glycemia induced neuron apoptosis and of reversal of the nerve function are warranted.
SDGs
Other Subjects
prokinetic agent; abdominal scintiscanning; article; autonomic neuropathy; celiac disease; constipation; decompression; diabetes mellitus; diabetic patient; diarrhea; diet restriction; disease severity; electrostimulation; esophagus candidiasis; esophagus disease; feces incontinence; feeding; gastritis; gastrointestinal motility disorder; gastrointestinal symptom; gastrostomy; gluten free diet; glycemic control; human; intestine innervation; jejunostomy; nerve function; prevalence; stomach emptying; stomach paresis
Type
journal article