complications of diabetes that affect the digestive system, including gastroparesis, delayed stomach emptying, constipation, diarrhoea, and other digestive issues. These Effects of diabetes on gastrointestinal systeml and other health problems. Learn how diabetes affects the GI system, what symptoms to watch for, and how to manage these problems and prevent further complications.

1.    
HOME ABOUT US HEALTH ISSUES 
HEALTH & MIND CONTACT US

Health Issues
Effects of diabetes on gastrointestinal
system
August 16, 2022 by admin     
Effects of diabetes on gastrointestinal system-means effects of diabetes specifically on the gut.
FAQs-
OUR NEWSLETTERS
Get our best recipes and tips in your

2. How does diabetes affect the gastrointestinal system ?
How does diabetes affect gastrointestinal motility ?
What disorders of the GI system are usually found in diabetes ?
Does diabetes cause stomach issues ?
For answers to all these questions pl go through the article given below –
If an individual is suffering from nausea, heartburn, or bloating one possibility of diabetes should
always remain in mind.
And vice-versa if an individual is already diagnosed with diabetes and he is having symptoms of
nausea, heart burn, bloating then these symptoms should not be ignored. It indicates that the
individual is suffering from gastroparesis .
Gastroparesis is a condition that affects how you digest your food.
Diabetes is the most common known cause of gastroparesis.
Medicines can help gastroparesis but not completely cure it.
It is due to affection of the nerve that innervates the stomach.
Thus peristalsis is affected and gastroparesis results .
In this case opinion should be taken from a physician (MD-General Medicine) or a
Gastroenterologist .
What is Gastroparesis ?
Normally during peristalsis the stomach muscles tighten so as to move the food down the
gastrointestinal tract .
However in diabetes due to damage to the nerves these muscles tighten less or do not move
at all.
Thus food takes comparatively longer time to move down the stomach.
This affects assimilation (time taken for the body to absorb food increases) .
Certain doses of insulin are required for certain doses of food, so the dose of insulin secreted by
the pancreas and the dose of food absorbed does not match .
This can lead to malnutrition
Frequent vomiting is a symptom of gastroparesis which can cause extreme thirst and dehydration.
Symptoms of gastroparesis –
Feeling stuffed after heavy food .
Feeling abdominal pain, bloating discomfort even after intake of small amount of food.
inbox. Sign up now!
CATEGORIES
LUNGS
NARCOLEPSY SYSTEM

3. Nausea vomiting and heart burn poor appetite can also occur.
If any of these symptoms occur consultation should be done with a physician (MD General
Medicine) or a Gastroenterologist.
Management of gastroparesis-
Medicine line of treatment –
Medicines will help but cannot completely cure gastroparesis.
Following actions should be taken –
Always try to keep blood sugar as close to normal range .
Frequent small meals should be taken that are low in fat and fibre .
The reason this should be done is that fat and fibre delay the emptying of the stomach and the
symptoms get aggravated.
To drink plenty of water -minimum 7-11 cups of water per day.
The physician or Gastroenterologist from whom the treatment is taken should be informed about
all the medications which are going on at present so that any drugs interactions
contraindications, adverse effects of drugs should be taken care of.
Any acidity causing drugs should be informed to the doctor.
Alcohol, smoking and other addictions should be given up.
Regular physical activity minimum 80 minutes per day.
Consultation with dietitician regarding proper diet advice.
Oral manifestations-
Xerostomia-dryness of mouth is found in 34-51 percent of diabetes patients.
Hyposalivation can result in difficulty in swallowing, speaking ,eating .
Sialosis (diffuse swelling of parotid glands which is non -neoplastic,non inflammatory, diffuse
asymptomatic is common in patients of diabetes .
Taste dysfunction, oral candidiasis( fungal infection) is common in patients of diabetes .
Deep neck bacterial infection.
Recurrent aphthous stomatitis.
Oral infection.
Periodontal problems,
Dental caries
Tooth loss.
RECENT POSTS
Tympanoplasty
March 28, 2023
Sore Throat Stuffy Nose
March 26, 2023
Complications Of Sinusitis
March 19, 2023
Chronic Otitis Media Effusion
March 18, 2023
Sinusitis
March 10, 2023
INSOMNIA

4. Lichen planus
Good oral hygiene and strictly controlling blood sugar can minimize these effects.
These things can decrease the morbidity and increase the quality of life.
Oesophageal candidiasis -This may be found in diabetic patients and usually presents with painful
swallowing and dysphagia .
Diagnosis of oesophageal candidiasis is by fibre optic oesophagoscopy and biopsy by
gastroenterologist.
Treatments include strictly controlling blood sugar and and anti fungal treatment.
Oesophageal dysmotility -Incidence of oesopphageal dysmotility in diabetes patients is 61 percent.
In this there is reduced peristalsis or no peristalsis.
It is usually asymptomatic but may cause regurgitation of food particles and dysphagia.
It is diagnosed by manometry.
Patient is advised diet modifications and to drink fluids immediately after pills.
Black oesophagitis -It is acute oesophageal necrosis and it is rare complication of acute diabetic
ketoacidosis.
Oesophageal perforation and stricture can occur.
Acute oesophageal perforation has a poor prognosis.
Management of acute oesophageal perforation includes oesophageal rest, gastric acid
suppression and treating the underlying cause.
GERD (Gastrooesophageal reflux disease) is more common in type -2 diabetes as compared to
non diabetics.
Erosive oesophagitis is more common in diabetic individuals with neuropathy .
Gastroesophageal disease is diagnosed by clinical features, treated by proton pump inhibitors ,or
H2 blockers and by lifestyle modifications.
Several factors like vagus nerve dysfunction,
glycemic excursions, decrease in expression neuronal nitric oxide synthase with in the myenteric
plexus on the enteric nervous system, disturbance/ loss of interstitial cell of Cajal (specialized
pacemaker cells),
and the existence of proinflammatory state due to excessive oxidative stress is responsible for
gastroparesis in diabetic gastroparesis .

5. Drugs used in Diabetes Mellitus to control blood sugar, such as GLP1 receptor agonists and
amylin analog (pramlinitide) are responsible for delayed gastric emptying.
Diagnosis of gastroparesis is done by upper GI endoscopy.
Technetium- labelled gastric emptying scintigraphy test with low-fat, egg-white, albumin-based
meal is the best for diagnosis of diabetic gastroparesis
Intestinal complications of diabetes –
The small intestine transit time in patients of diabetes mellitus is abnormal such as slow or rapid
and up to 80% patients with diabetic gastroparesis patients do not have intestinal peristalsis in
the normal range.
Due to involvement of enteric nerves of the small intestine in diabetes, there is abnormal motility,
secretion, or absorption in the small intestine which leads to delayed peristalsis and stagnation of
fluids, resulting in bacterial overgrowth and infection bloating, diarrhea and abdominal pain. Small
intestinal bacterial overgrowth is found in up to 40% of diabetic patients with diarrhea . Though
the diagnostic test requires small-bowel intubation, aspiration of small intestinal fluid and
quantitative cultures of fluid, Breath hydrogen testing and the (14C)-D-xylose test is useful in
diagnosis of SIBO .
SIBO is treated by short term or intermittent (in case of recurrent SIBO) use of antibiotics. Rifaximin is
the mostly used in SIBO treatment.
Diabetes is associated with various complications involving the gastrointestinal tract, biliary tree,
pancreas, and liver ,stomach, intestine.
Up to 75% of patients with longstanding diabetes report chronic or intermittent GI complaints resulting
from abnormal sensory or motor function of the gut. Patient with diabetes may have altered function of
multiple organs of the digestive system .
Diabetic Gastroparesis/Gastropathy
Definition: Diabetic gastropathy is a term used to collectively describe all disorders that occur as a
result of autonomic neuropathy affecting the stomach. The most severe disorder is gastroparesis which
is defined by delayed gastric emptying in the absence of mechanical obstruction. Approximately 40% of
patients with type 1 diabetes and 10-20% of patients with type 2 diabetes will develop gastroparesis.
Following is the grading system for gastroparesis:
Grade 1–symptoms controlled with maintenance of weight and nutrition on a standard diet

6. Grade 2–moderate symptoms with partial control on prokinetic and antiemetic medications and ability
to maintain nutrition with dietary modifications
Grade 3–refractory, uncontrolled symptoms requiring frequent emergency department and clinic visits
or hospitalizations and/or inability to maintain nutrition orally
Symptoms and Signs: Patients with diabetic gastropathy may present with nausea and vomiting (45%),
abdominal pain or discomfort (20%), bloating (7%), early satiety, and postprandial fullness. Vomiting
typically occurs 30-60 minutes after eating but may occur up to 8 hours after oral intake. Patients with
frequent or refractory vomiting may have loss of dental enamel, GI bleeding from tearing of the
gastroesophageal junction (Mallory-Weiss tear) or hemorrhagic gastropathy. Abdominal pain is typically
postprandial and described as vague burning, crampy, sharp, or pressure-like. Symptoms in diabetic
gastroparesis are chronic in >50% of patients but may also occur in a cyclical nature in up to 10%.
The Gastroparesis Cardinal Symptom Index (GCSI) is a validated symptom survey composed of nine
symptoms and often used in clinical investigation and patient care (Table II). There are no
pathognomonic signs in patients with diabetic gastroparesis but in severe cases may include a
succussion splash on auscultation.
Small Intestinal Bacterial Overgrowth
Definition: Small intestinal bacterial overgrowth (SIBO) is a condition that develops as a consequence of
excessive bacteria colonized in the small intestine. Bacterial metabolism of food residue delivered into
the small intestine promotes generation of gases (hydrogen, methane) and other by-products .
Patients with GI motility disorders (e.g., gastroparesis, small bowel dysmotility), such as those seen in
patients with longstanding diabetes due to injury of the enteric nervous system, are having higher
possibilities for developing SIBO.
Symptoms and Signs: Symptoms of SIBO include bloating, distention, flatulence, eructation, abdominal
discomfort, diarrhea, or weight loss. The predominant symptoms depends on the type of microbial flora
present in the individual patients. Patients with bacteria that metabolize carbohydrates to short-chain
fatty acids and gaseous by-products.Such individuals primarily report bloating symptoms. On the other
hand, bacteria that metabolize bile salts to insoluble compounds result in diarrhea or other clinical
features of fat malabsorption. The physical examinstion in most patients with SIBO shows visible
abdominal distention on inspection or on percussion.
Diabetic Constipation

7. Diabetic constipation shows presence of decreased stool frequency, straining with defecation, lumpy or
hard stools, sensation of incomplete evacuation, or need for enema for defecation. Constipation is
reported in approximately 66 percent of patients with diabetes.Diabetic constipation is a result of
neuropathy leading to decreased colonic motility and decreased gastrocolic reflex.
Symptoms and Signs: Patients with diabetic constipation report a range of bowel disturbances
including infrequent passage of hard stools and they have to strain a lot further passage of stools .
Additional clinical features due to constipation may include bloating, distention, abdominal pain,
discomfort, and fullness. Physical examination -On digital anorectal examination one may find hard,
firm stool in the rectal vault.
Diabetic Diarrhoea
Diabetic diarrhea means passage of frequent or loose stools occurring as a consequence of
longstanding diabetes. The pathogenesis of this condition is multifactorial Diets with large amounts of
poorly absorbed carbohydrates (e.g., sorbitol that is commonly used in sugar free foods) can cause
diarrhea due to osmosis. Patients with SIBO may have mucosal injury, malabsorption, indigestion
problems. Increased delivery of unconjugated bile acids to the colon triggers fluid and electrolyte
secretion. Type 1 diabetes is associated with other autoimmune disorders (e.g., celiac disease,
Addison’s disease) which commonly cause diarrhea.
Finally, a subset of diabetics with diarrhea exhibit a true secretory diarrhea due to loss of balance
between cholinergic intestinal secretion and impaired adrenergic absorption.
Symptoms and Signs: Diabetics with diarrhea will complain about passage of loose and/or frequency
of stools is increased. Nocturnal symptoms are dependant on the underlying etiology for the patient’s
diarrhea. If there is associated malabsorption due to associated SIBO, celiac disease, or pancreatic
insufficiency, patients may also experience bloating, distention, flatulence, weight loss, or steatorrhea.
Many patients with high volume liquid stool output will experience fecal incontinence.
Fecal Incontinence-
Fecal incontinence refers to inadvertent expulsion of feces in which voluntary control is lost. In
diabetic patients, this complication is due to affection of nerves that may affect both the internal and
external anal sphincters. Symptoms may be further increased by the presence of loose or liquid stools.
Symptoms and Signs: Diabetics with fecal incontinence may have varying degrees of symptoms,
ranging from minor soiling to excretion of large amounts of stool and adult incontinence undergarments
are required in this case.

8. In patients with associated rectal sensory neuropathy, the presence of stool in the rectum may be
unrecognized prior to its uncontrolled passage.
Episodes of fecal incontinence may occur during sleep.
Digital rectal examination of the diabetic with fecal incontinence may show presence of anal neuropathy
including decreased anal tone, weak squeeze pressure . Loss of the anal wink reflex is there.
Biliary manifestations of diabetes- Choledocholithiasis -For this there is requirement of endoscopic
retrograde cholangiopancreatography with sphincterotomy and stone extraction. Cholecystectomy is a
procedure that many be required in a patient with an episode of choledocholithiasis or cholecystitis.
Pancreatic:
Pancreatic enzyme supplementation is given with meals and snacks in patients with evidence of fat
malabsorption.
Hepatic: At present even in modern times there are currently no medications to specifically treat
hepatic steatosis. The present line of management is to optimize glycemic and lipid control, diet,
exercise, and weight loss. Patients with progression to cirrhosis will require liver transplantation in the
end.
For symptoms of diabetes pl click on the link given below
https://healthuseful.com/symptoms-of-diabetes/
For effects of diabetes on skin -part-1 pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-the-skin/
For effects of diabetes on skin part -2, pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-skin-part-2/
For effects of diabetes on wounds and infections pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-wounds-and-infections/

9. You May Also Like
For effects of diabetes on blood vessels pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-blood-vessels/
For effects of diabetes on vision pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-vision/
For effects of diabetes on kidneys pl click on the link given below
https://healthuseful.com/effects-of-diabetes-on-kidneys/
For effects of diabetes on nervous system pl click on the link given below
https://healthuseful.com/effect-of-diabetes-on-nervous-system/
   
PREVIOUS
Drugs to be avoided in certain circu…
NEXT
What is Septoplasty Surgery ?
 

10. PDFmyURL.com - convert URLs, web pages or even full websites to PDF online. Easy API for developers!
Address
Prabha ENT Clinic
📍Plot no 345, Saigram colony, Opposite
Indoline furniture, Ambad link road,
Ambad, 1 km from Pathardi Phata, Nashik,
422010, Maharashtra
 +91 7387590194 ,9892596635
 positivemindhealthcare@gmail.com
Quick Link
Home
About Us
Ear
Health Issue
Health & Mind
Contact Us
Terms and Conditions
ENT Specialist in Nashik
Location
© 2022 Positivemind Healthcare   
Health Blog
Tympanoplasty
MARCH 28, 2023
Health Blog
Sore Throat Stuffy Nose
MARCH 26, 2023
Nose
Complications Of Sinusitis
MARCH 19, 2023