There are several reasons for this, including nerve damage because of high or uncontrolled blood sugar.
Gastrointestinal (GI) symptoms can vary, ranging fromacid refluxtodiarrheatoconstipation.
Ingastroparesis, the stomach empties food out slower than it should.
Illustration by Theresa Chiechi for Verywell Health
It also can increase pressure inside the stomach.
The increased pressure puts stress on the LES.
Esophageal dysmotilitycan develop in people with diabetes.
“Dysmotility” means that the muscles of the esophagus are not working well.
This includes food moving too slowly or even muscle spasms.
It can lead to symptoms such as heartburn and regurgitation.
The symptoms include abdominal discomfort and early satiety (feeling full).
Gastroparesis may be triggered by nerve damage that is related to diabetes.
Long periods of higher-than-normal blood sugar can damage the nerves, which is calledautonomic neuropathy.
This might also affect the nerves in various parts of the body, including the stomach.
Diabetic Enteropathy
Diabetes can cause nerve damage, calledneuropathy.
This nerve damage can extend to internal organs, including the intestines.
Diabetic neuropathy is associated with having uncontrolled glucose levels and having diabetes for a longer time.
It may occur as a result of enteropathy.
This complication can affect up to 60% of people with long-standing diabetes.
Complications from constipation are rare.
However, constipation can significantly reduce a persons quality of life.
Diabetic medications can also cause diarrhea.
Fecal Incontinence
Fecal incontinence is losing control of the bowel and having bathroom accidents.
This could lead to leaking or loss of control.
Hyperglycemia(high blood sugar) and rapid changes in glucose levels are also associated with incontinence.
Fecal incontinence is sometimes not recognized or managed well.
It can be associated with other GI conditions, such as gastroparesis and GERD.
Around 74% of people with diabetic enteropathy report abdominal pain.
Food moving too slowly through the small intestine can occur in people with diabetes.
Symptoms of SIBO include bloating, diarrhea, and abdominal discomfort.
SIBO is fairly common.
It affects about 15% to 40% of people with diabetes.
For those who have diarrhea, SIBO may be more prevalent.
Treatment
The treatment for digestive problems associated with diabetes will depend on the diagnosis.
It’s also important to look into any other digestive conditions that could be causing symptoms.
GERD
To treat GERD, weight loss might be recommended, when appropriate.
A gastric pacemaker is placed surgically.
In gastroparesis, theres a need to ensure that nutritional needs are met.
People might need supportive care if they are experiencing dehydration, electrolyte imbalances, and nutrient deficiencies.
This can include working with a dietitian to create an eating plan.
Diabetic enteropathy can cause a wide range of digestive symptoms.
Having improved blood glucose control will be a major focus.
After that, treating symptoms like diarrhea or conditions like SIBO might be the next step.
Laxatives might be of help, but they should only be used under the direction of a healthcare provider.
Few prescription medications are available for treating constipation, but Amitiza (lubiprostone) might be tried.
Diarrhea
Diarrhea can be from various causes that may or may not be related to diabetes.
This can include adding fiber to the diet or antidiarrheal drugs.
Biofeedback therapyorbowel retrainingare other options that may be available and helpful for some people.
Abdominal pain can be from various causes, and treating underlying diabetes or other issues may help.
Biofeedback or referral to a pain specialist may also be considered.
Prevention
It may not always be possible to prevent the digestive complications of diabetes.
However, maintaining good glucose control and getting regular care from a healthcare provider may help.
In some cases, they may result from nerve damage to the digestive system.
Receiving proper care for diabetes is important to managing symptoms and preventing complications.
Theres so much stigma surrounding digestive problems, especially with accidents.
This includes the nervous system.
People with diabetes may experience bloating or gas.
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