Diabetes patients are more likely to experience gastrointestinal issues. Actually, people with diabetes are more likely to get GI issues like ulcers, gallstones, IBS, or other GI disorders at some point in their lives. GI issues are reported by up to 75% of diabetic individuals to their doctors.
Ignored or misinterpreted
Even though many people have identical symptoms, the diagnosis is not always the same and is frequently first incorrect. Diabetes can cause harm and complications to the entire gastrointestinal tract, from the mouth to the esophagus and finally to the anorectal region.
Diagnosing and treating GI disorders in diabetic individuals is complicated by the intricate nature of GI symptoms and the region of the gastrointestinal tract they affect.
Diabetes and GI disorders were not previously linked. This might result in incorrect diagnoses, illnesses that are missed, or even inappropriate therapies. Contrary evidence has started to emerge, which is contributing to a rise in GI disorders and problems among diabetics.
Blood Sugar Regulation and Its Association with Digestive Disorders
Gastrointestinal problems can result from both acute and long-term high blood sugar episodes. Furthermore, as is often the case with other diabetes complications, inadequate blood sugar regulation is linked to more serious GI problems.
Individuals who have neuropathy and retinopathy ought to get evaluated for gastrointestinal disorders. Gastrointestinal problems may arise from abnormalities in the neurons supplying the body’s enteric nervous system. Enteric neuropathy can also be caused by the body’s intestinal nerves, much as neuropathy in the feet.
This kind of neuropathy, called autonomic neuropathy, can cause abnormalities in the body’s nutrient absorption and secretion processes. Damage to the intestinal neurons that control the intestinal system’s motility and function can either increase or reduce the rate at which the intestinal system functions.
GI Disorders That Are Common in People with Diabetes
Although the gastrointestinal tract is complex and many individuals with diabetes may experience a wide range of GI disorders, there are a few more prevalent ones that they are frequently diagnosed with. Among them are:
The gastroparesis
A disorder known as gastroparesis causes the stomach’s contents to remain in the stomach due to a delayed process of emptying the food inside. Gastritis frequently causes bloating, stomach distention, pain in the abdomen, vomiting, and nausea in its victims. Many persons with gastroparesis are unable to handle foods heavy in fat or fiber, which can exacerbate reflux and heartburn symptoms.
Identifying Gastropia
Symptoms alone are often enough to identify gastroparesis in many people. Nevertheless, more examinations are carried out to validate this diagnosis.
Although an upper GI endoscopy can exclude any obstructions in the duodenum or stomach, it is unable to provide a precise image of the gastric emptying process. It might be required to do an upper GI barium exam in order to confirm the delay in stomach emptying.
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Gastroparesis Treatment
In addition to managing diabetes, there are numerous gastroparesis treatments available to assist relieve symptoms. More frequent little meal consumption may help people feel some alleviation. Foods heavy in fiber and fat should be avoided.
When symptoms worsen, a liquid diet may be advised, and parenteral hydration and alimentation may be required. In the most extreme cases of gastroparesis, a nasogastric tube suction might also be employed. For people with gastroparesis, there are pharmacological treatments that aid in the process of gastric emptying.
Candida Outbreaks
Diabetes patients are susceptible to developing GI tract yeast infections, particularly if their blood sugar is poorly controlled. Thrush is a yeast infection of the mouth that is characterized by a white coating on the tongue and throat, along with burning and discomfort. Candida esophagitis may result from a yeast infection that spreads farther into the gastrointestinal tract.
This may result in intestinal hemorrhage, heartburn, and trouble swallowing. An examination can diagnose thrush or oral candida, but an endoscopy might be necessary to diagnose candida esophagitis. Oral antifungal drugs are a highly effective treatment for both, helping to completely remove the yeast infection.
Digestive Disorders
Indigestion, heartburn, and a burning sensation in the abdomen can all be caused by an acid irritation in the stomach or even the esophagus. Helicobacter pylori (H pylori) is a particular type of bacteria that causes duodenal and stomach ulcers.
Ant secretory medications are used to reduce stomach acid in the treatment of ulcer disease. In addition, antibiotics may be administered when H. Pylori is detected. Patients suffering from gastro esophageal reflux disease may need to be treated with proton pump inhibitors since eliminating the H. pylori bacteria frequently makes their symptoms worse.
Small Intestine Enteric Neuropathy
Long-term consequences of diabetes may harm the enteric nerve that supplies the small intestine. Anomalous intestinal motility, absorption, and secretion may result from this injury. There may be symptoms like diarrhea and bloating in the abdomen.
Bacterial overgrowth may also become more prevalent if digestive fluids take longer to drain. It could be essential to use broad range antibiotics to stop the growth of bacteria in the small intestine.
Similar to peripheral neuropathy in the feet, which can develop over time as a consequence of diabetes, enteric neuropathy can similarly cause persistent pain in the abdomen. Medications for pain and antidepressants are used in the treatment of chronic enteric neuropathy.
Connection Between Diabetes and Celiac Disease
Diabetes also increases the chance of getting celiac disease, a disorder where eating gluten, which is frequently present in wheat, can harm the small intestine. The body launches an immunological attack on the small intestine in people with celiac disease when they eat gluten.
The villi on the intestinal wall that aid in nutrient absorption sustain more damage as a result of this onslaught. The body’s villi become destroyed and become incapable of effectively absorbing nutrients.
An endoscopic biopsy of the small intestine and a lab test for anti-gliadin and anti-endomysial antibodies are used to identify celiac disease. Currently, the only available treatment for celiac disease is rigorous adherence to a gluten-free diet. Other names for celiac disease include gluten-sensitive enteropathy and coeliac disease.
Liver disease or fatty infiltration
People with Type 2 diabetes frequently have fatty infiltration of the liver as a result of poor blood sugar regulation. Abdominal pain and increased liver enzymes can result from fatty infiltration. It can occasionally develop into cirrhosis or even fibrosis.
Although an examination can make a diagnosis, it needs to be verified by an abdominal ultrasound or, if required, a percutaneous liver biopsy. The goals of treatment programs are to enhance blood sugar regulation and encourage a low-calorie diet.
Conclusion
Unfortunately, digestive issues are highly prevalent in diabetics, but they are rarely identified in clinical settings. When GI symptoms appear, it’s important to examine the patient’s blood sugar management and the length of time they’ve had diabetes.
These disorders can be difficult to diagnose and treat since they can affect the entire gastrointestinal tract. You should see your doctor right away if you have been having GI problems or symptoms so that you may discuss the possibility of GI conditions and potential treatment options that could help you feel better.
Citations:
DiabetesCouncils Article | Reviewed by Dr. Christine Traxler MD on May 24, 2020
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