When I initially see a diabetic patient, they often have complaints and concerns happening within their gastrointestinal systems. These symptoms can range from increased gas and bloating, to nausea and vomiting to diarrhea and constipation. You could almost diagnosis IBS (Irritable Bowel Syndrome) in most diabetic patients. The unfortunate part of this scenario is that most patients with these symptoms are using a lot of different over-the-counter antacids, anti-diarrhea and constipation treatments to try and manage these symptoms. This direction of care only continues to enable the individual down a path of symptom suppression with the need to use stronger treatments to get an improvement in the symptom response. Based on the principle of “treating the cause and not the symptom”, I would like to discuss the reason behind why diabetics deal with increased digestive problems and what are some beneficial ways of addressing the underlying cause.
When it comes to function in the body, the nervous system is at the top. All of the tissues that make up your organs, muscles, tendons and ligaments are innervated (meaning they have a nerve going into them, much the same way an electrical wire needs to go into a plug to give it power). This innervation is what stimulates the tissues to do its function. So for instance in the muscles, the nerve creates muscular contraction. In the organs, such as the stomach, this innervation causes enzymes to be produced. In the small bowel it causes digestion to occur. In the large bowel, it causes peristalsis to occur (which is the movement of the the tissue to aid in bowel function). As you can see, nerves play a vital role in initiating activity to occur in the body.
So why are diabetics challenged when it comes to their digestion? It has to do with the nerves. To understand this further, let us talk about diabetic neuropathy. This is a common condition that diabetics deal with mostly in their lower legs and feet. Neuropathy occurs because the elevation of blood glucose in diabetes affects the small blood vessels that feeds these nerves. As the glucose rises, it wears down the integrity of the blood vessel preventing adequate blood from getting to the nerve and allowing it to function correctly. The lack of blood flow to the nerve slows down function of the tissue it is innervating and creates pain as a signal of feedback.
This general understanding of neuropathy gives you the basis behind the cause of gastrointestinal symptoms in diabetics. A thing to remember is that if you are having diabetic neuropathy in one part of your body, you are having it everywhere. Thus, the cause of intestinal issues in diabetics can be from neuropathy. You want to avoid using medications such as Lyrica when you are having neuropathy because you are just covering up the symptoms without an ability to get feedback from your body. The wearing down of the nerve tissue and the subsequent reduction of function in the organs is what causes gastrointestinal symptoms to occur. Thus it is important to regulate the elevated blood glucose to allow better circulation and blood to return to the nerves. This will improve the digestive symptoms that occur as a result of diabetes.
Dr.Buttler, educating people about diabetes in the Milwaukie and Portland areas.