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Diabetes Related Intestinal Enteropathy
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Diabetes Related Intestinal Enteropathy
See Also
Intestinal Enteropathy
Gastrointestinal Manifestations of Diabetes Mellitus
Diabetes Mellitus Complications
Gastroparesis
Nonalcoholic Fatty Liver Disease
Immune dysregulation, polyendocrinopathy, enteropathy, X-linked Syndrome
(
IPEX Syndrome
)
Pathophysiology
Gene
ral
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
Bacteria
l 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]
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