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Diabetes Related Intestinal Enteropathy
Aka: Diabetes Related Intestinal Enteropathy
- See Also
- Intestinal Enteropathy
- Gastrointestinal Manifestations of Diabetes Mellitus
- Diabetes Mellitus Complications
- Gastroparesis
- Nonalcoholic Fatty Liver Disease
- Pathophysiology
- General
- Autonomic Neuropathy
- Diarrhea mechanisms (esp. Type I Diabetes Mellitus)
- Stasis syndrome due to impaired Small Bowel motility
- Hypermotility due to unmitigated sympathetic activity
- Pancreatic insufficiency
- Bile salt malabsorption
- Steatorrhea
- Drug-induced causes (e.g. Metformin)
- Constipation mechanisms
- Large Bowel dysfunction due to Neuropathy
- Impaired gastrocolic reflex
- Fecal Incontinence mechanisms
- Anal sphincter dysfunction related to Neuropathy
- Abnormal resting tone of internal and external anal sphincter
- Symptoms
- Diarrhea (occurs in up to 22% of patients with diabetes)
- Constipation (occurs in up to 44% of patients with diabetes)
- Fecal Incontinence
- Labs
- Thyroid Stimulating Hormone (TSH)
- Management: Diarrhea
- Maintain adequate hydration, Electrolyte replacement, and nutritional maintenance
- Symptomatic relief with antidiarrheal agents
- Avoid over-use due to Megacolon risk
- Bacterial overgrowth treatment
- Trial used Augmentin for 10 days in patients with positive hydrogen breath tests
- Virally-Monod (1998) Diabetes Metab 24:530-6 [PubMed]
- Management: Constipation
- Eliminate Medication Causes of Constipation
- See Constipation Management
- References
- Careyva (2016) Am Fam Physician 94(12): 980-6 [PubMed]
- Maleki (1998) Dig Dis Sci 43: 2373-8 [PubMed]
- Shakil (2008) Am Fam Physician 77: 1697-704 [PubMed]