Abstract
Motility disturbances of the colon can give significant symptoms in patients with diabetes mellitus. Constipation is a common complaint in these patients. Diarrhea associated with a generalized autonomic neuropathy can be very troublesome. There is a disturbance in the gastrocolonic response to eating in patients with diabetes mellitus who have constipation. These patients have no postprandial increase in colonic motility. However, their colonic smooth muscle contracts normally to the exogenous administration of neostigmine or metoclopramide. Stool softeners used in combination with the smooth muscle stimulants (neostigmine or metoclopramide) are helpful in treating constipation in patients with diabetes mellitus. Diarrhea can be treated with loperamide or diphenoxylate. Biofeedback may be useful in treating incontinence associated with diarrhea in these patients.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Battle W. M., Snape W. J., Jr, Alavi A., Cohen S., Braunstein S. Colonic dysfunction in diabetes mellitus. Gastroenterology. 1980 Dec;79(6):1217–1221. [PubMed] [Google Scholar]
- Berenyi M. R., Schwarz G. S. Megasigmoid syndrome in diabetes and neurologic disease. Review of 13 cases. Am J Gastroenterol. 1967 Apr;47(4):311–320. [PubMed] [Google Scholar]
- Bortoff A. Current concepts: intestinal motility. N Engl J Med. 1969 Jun 12;280(24):1335–1337. doi: 10.1056/NEJM196906122802406. [DOI] [PubMed] [Google Scholar]
- Cerulli M. A., Nikoomanesh P., Schuster M. M. Progress in biofeedback conditioning for fecal incontinence. Gastroenterology. 1979 Apr;76(4):742–746. [PubMed] [Google Scholar]
- Christensen J. Myoelectric control of the colon. Gastroenterology. 1975 Mar;68(3):601–609. [PubMed] [Google Scholar]
- Ewing D. J., Campbell I. W., Burt A. A., Clarke B. F. Vascular reflexes in diabetic autonomic neuropathy. Lancet. 1973 Dec 15;2(7842):1354–1356. doi: 10.1016/s0140-6736(73)93323-0. [DOI] [PubMed] [Google Scholar]
- Faulk D. L., Anuras S., Christensen J. Chronic intestinal pseudoobstruction. Gastroenterology. 1978 May;74(5 Pt 1):922–931. [PubMed] [Google Scholar]
- Feldman M., Corbett D. B., Ramsey E. J., Walsh J. H., Richardson C. T. Abnormal gastric function in longstanding, insulin-dependent diabetic patients. Gastroenterology. 1979 Jul;77(1):12–17. [PubMed] [Google Scholar]
- Feldman M., Schiller L. R. Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med. 1983 Mar;98(3):378–384. doi: 10.7326/0003-4819-98-3-378. [DOI] [PubMed] [Google Scholar]
- Fox S., Behar J. Pathogenesis of diabetic gastroparesis: a pharmacologic study. Gastroenterology. 1980 Apr;78(4):757–763. [PubMed] [Google Scholar]
- Goldstein F., Wirts C. W., Kowlessar O. D. Diabetic diarrhea and steatorrhea. Microbiologic and clinical observations. Ann Intern Med. 1970 Feb;72(2):215–218. doi: 10.7326/0003-4819-72-2-215. [DOI] [PubMed] [Google Scholar]
- Hollis J. B., Castell D. O., Braddom R. L. Esophageal function in diabetes mellitus and its relation to peripheral neuropathy. Gastroenterology. 1977 Nov;73(5):1098–1102. [PubMed] [Google Scholar]
- Katz L. A., Spiro H. M. Gastrointestinal manifestations of diabetes. N Engl J Med. 1966 Dec 15;275(24):1350–1361. doi: 10.1056/NEJM196612152752406. [DOI] [PubMed] [Google Scholar]
- Low P. A., Walsh J. C., Huang C. Y., McLeod J. G. The sympathetic nervous system in diabetic neuropathy. A clinical and pathological study. Brain. 1975 Sep;98(3):341–356. doi: 10.1093/brain/98.3.341. [DOI] [PubMed] [Google Scholar]
- McNally E. F., Reinhard A. E., Schwartz P. E. Small bowel motility in diabetics. Am J Dig Dis. 1969 Mar;14(3):163–169. doi: 10.1007/BF02235877. [DOI] [PubMed] [Google Scholar]
- Miranda P. M., Horwitz D. L. High-fiber diets in the treatment of diabetes mellitus. Ann Intern Med. 1978 Apr;88(4):482–486. doi: 10.7326/0003-4819-88-4-482. [DOI] [PubMed] [Google Scholar]
- PALEY R. G., MITCHELL W., WATKINSON G. Terminal colonic dilation following intractable diarrhea in a diabetic. Gastroenterology. 1961 Oct;41:401–407. [PubMed] [Google Scholar]
- Palmer K. R., Corbett C. L., Holdsworth C. D. Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology. 1980 Dec;79(6):1272–1275. [PubMed] [Google Scholar]
- Read N. W., Harford W. V., Schmulen A. C., Read M. G., Santa Ana C., Fordtran J. S. A clinical study of patients with fecal incontinence and diarrhea. Gastroenterology. 1979 Apr;76(4):747–756. [PubMed] [Google Scholar]
- Russell C. O., Gannan R., Coatsworth J., Neilsen R., Allen F., Hill L. D., Pope C. E., 2nd Relationship among esophageal dysfunction, diabetic gastroenteropathy, and peripheral neuropathy. Dig Dis Sci. 1983 Apr;28(4):289–293. doi: 10.1007/BF01324943. [DOI] [PubMed] [Google Scholar]
- Scarpello J. H., Barber D. C., Hague R. V., Cullen D. R., Sladen G. E. Gastric emptying of solid meals in diabetics. Br Med J. 1976 Sep 18;2(6037):671–673. doi: 10.1136/bmj.2.6037.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scarpello J. H., Sladen G. E. Diabetes and the gut. Gut. 1978 Dec;19(12):1153–1162. doi: 10.1136/gut.19.12.1153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schiller L. R., Santa Ana C. A., Schmulen A. C., Hendler R. S., Harford W. V., Fordtran J. S. Pathogenesis of fecal incontinence in diabetes mellitus: evidence for internal-anal-sphincter dysfunction. N Engl J Med. 1982 Dec 30;307(27):1666–1671. doi: 10.1056/NEJM198212303072702. [DOI] [PubMed] [Google Scholar]
- Schulze-Delrieu K. Drug therapy. Metoclopramide. N Engl J Med. 1981 Jul 2;305(1):28–33. doi: 10.1056/NEJM198107023050106. [DOI] [PubMed] [Google Scholar]
- Smith B. Effect of irritant purgatives on the myenteric plexus in man and the mouse. Gut. 1968 Apr;9(2):139–143. doi: 10.1136/gut.9.2.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson M. A., Summers R. Barium impaction as a complication of gastrointestinal scleroderma. JAMA. 1976 Apr 19;235(16):1715–1717. [PubMed] [Google Scholar]
- Wald A. Biofeedback therapy for fecal incontinence. Ann Intern Med. 1981 Aug;95(2):146–149. doi: 10.7326/0003-4819-95-2-146. [DOI] [PubMed] [Google Scholar]
- Whalen G. E., Soergel K. H., Geenen J. E. Diabetic diarrhea. A clinical and pathophysiological study. Gastroenterology. 1969 Jun;56(6):1021–1032. [PubMed] [Google Scholar]