Gastrointestinal complications of diabetes

Amer Shakil, Robert J. Church, Shobha S. Rao

Research output: Contribution to journalReview article

66 Citations (Scopus)

Abstract

Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications.

Original languageEnglish (US)
JournalAmerican Family Physician
Volume77
Issue number12
StatePublished - Jun 15 2008
Externally publishedYes

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Gastroparesis
Diabetes Complications
Blood Glucose
pioglitazone
Constipation
Transaminases
Diarrhea
Fecal Incontinence
Metoclopramide
Hemochromatosis
Metformin
Gastric Emptying
Liver
Dietary Fiber
Erythromycin
Tobacco Products
Radionuclide Imaging
Nausea
Abdominal Pain
Hepatitis

ASJC Scopus subject areas

  • Family Practice
  • Medicine(all)

Cite this

Shakil, A., Church, R. J., & Rao, S. S. (2008). Gastrointestinal complications of diabetes. American Family Physician, 77(12).

Gastrointestinal complications of diabetes. / Shakil, Amer; Church, Robert J.; Rao, Shobha S.

In: American Family Physician, Vol. 77, No. 12, 15.06.2008.

Research output: Contribution to journalReview article

Shakil, A, Church, RJ & Rao, SS 2008, 'Gastrointestinal complications of diabetes', American Family Physician, vol. 77, no. 12.
Shakil A, Church RJ, Rao SS. Gastrointestinal complications of diabetes. American Family Physician. 2008 Jun 15;77(12).
Shakil, Amer ; Church, Robert J. ; Rao, Shobha S. / Gastrointestinal complications of diabetes. In: American Family Physician. 2008 ; Vol. 77, No. 12.
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