ABSTRACT
Gastrointestinal symptoms are frequently encountered in patients with diabetes mellitus. Diabetic enteropathy may result in dysphagia, heartburn, nausea and vomiting, abdominal pain, constipation, diarrhea, and fecal incontinence (7). Although not generally considered important causes of morbidity in diabetic patients, these symptoms can be encountered in up to 75% of diabetic outpatients evaluated at a tertiary referral center. The prevalence of gastrointestinal symptoms among community diabetic patients is, however, lower. A recent questionnaire- based study in Olmsted County, Minnesota, showed that only constipation and use of laxatives were more prevalent in diabetics than in controls matched for age and gender (17). The high prevalence of functional gastrointestinal disorders, such as irritable bowel syndrome, constipation, and functional dyspepsia in Western civilizations confounds any estimates of the prevalence of diabetic enteropathy based on symptoms alone. Nonetheless, the nature of the symptoms suggests that many may result from motor and sensory abnormalities of the gastrointestinal tract, which reflects alterations in neural control, impaired intestinal absorption or secretion, and deranged pancreatic function (Fig. 1).
