People may know that diabetes puts them at higher risk for things like heart disease and obesity, but it may also be found to cause abnormalities in other parts of the gut and gastrointestinal tract.
Poor blood sugar control can damage nerves, including those in the gastrointestinal tract. In fact, people with diabetes also have gastrointestinal problems.
Constipation is one of the most common symptoms, but other symptoms may also occur. It is important to pay attention to the onset of gastrointestinal-related symptoms so that your doctor can help manage them. The following is a list of the most common gastrointestinal-related conditions associated with diabetes.
Gastroparesis
The main nerve in the gastrointestinal tract (called the vagus nerve) sends signals to the muscles that push food from the stomach to the small intestine. If diabetes damages the vagus nerve, the delivery of food slows down or stops on the way from the stomach to the small intestine, which is called gastroparesis (or delayed gastric emptying). Gastroparesis is more common in women than in men.
Symptoms include:
- Feeling bloated after eating a small amount of food;
- Bloating or discomfort after a meal;
- Vomiting or nausea;
- Pain in the upper abdomen.
In some cases, gastroparesis can make it difficult to control blood sugar levels, which may be the first symptom of having diabetes.
There are several treatment options for gastroparesis. In mild cases of gastroparesis, dietary changes alone can relieve symptoms. If dietary changes don’t work, medications may work. In severe cases, doctors may have to implant a stimulator in the stomach to encourage the stomach muscles to resume their emptying action.
Diabetic enteropathy
Intestinal disease is a disease of the intestines. If you have gastroparesis, you are at a higher risk of developing bowel disease. If you have had diabetes for a long time, you may also have abnormalities in the small intestine, colon, or rectum.
Diabetes-related nerve damage in the gut can cause the body to slow down or even stop digesting the food it ingests, which can then lead to constipation and cause harmful bacteria to multiply. As a result, diarrhea, or constipation, may occur. Diarrhea is the most common symptom of bowel disease.
The stool may leak out of the rectum and the patient may have difficulty controlling the bowel movement on their own. The problem may be further exacerbated by the use of meals.
The doctor may rule out other possible causes, such as diet, medications, or disease (e.g., thyroid disease).
If you have diabetic bowel disease, your doctor will try to help keep your blood sugar stable to control your symptoms.
Non-alcoholic fatty liver disease
This disease is an abnormal accumulation of fat cells in the liver of people who drink little or no alcohol. This type of liver disease is very similar to alcoholic liver disease. If you have diabetes or are obese, you are at risk for developing nonalcoholic fatty liver disease.
If you have nonalcoholic fatty liver disease, you will find it difficult to control your diabetes because the more fat in your liver, the harder it is for your body to use insulin and respond to it.
Most nonalcoholic fatty liver disease is asymptomatic. If symptoms do occur, they may just be fatigue or pressure pain in the upper left side of the stomach. The first sign is usually an elevated glutamate transaminase (ALT) on a blood test, and clinically ALT measures liver function.
There is no specific treatment for nonalcoholic fatty liver disease. However, your doctor may recommend blood glucose control and may recommend weight loss. Or, medications may be prescribed to promote better use of insulin by the body.
Diabetes affects the gastrointestinal tract
Diabetes can cause problems in the gastrointestinal tract. Nerve abnormalities in the esophagus may lead to heartburn and difficulty swallowing. The doctor will tell the patient what range of blood glucose to keep under control in order to manage gastrointestinal symptoms. Antacids may also be prescribed or recommended as well as the dose of medication that should be taken.
Other gastrointestinal disorders that are more common in patients with diabetes include:
- Hepatitis C (liver infection);
- Cirrhosis (scar tissue in the liver);
- Hemochromatosis (excess iron stores leading to liver damage).
If a new onset of intestinal disease develops or if this type of disease persists, it is important to seek medical attention.