Current Treatment Options in Gastroenterology

, Volume 15, Issue 4, pp 460–474 | Cite as

Diabetes Mellitus and the Colon

  • Marc S. Piper
  • Richard J. SaadEmail author
Motility (H Parkman and R Schey, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Motility

Opinion statement

Diabetes mellitus (DM) can affect the structure and function of the colon promoting commonly encountered lower gastrointestinal symptoms such as constipation, diarrhea, abdominal distention, bloating, and abdominal pain. Specific colonic disorders for which adults with DM are at greater risk include chronic constipation, enteropathic diarrhea, colorectal cancer (CRC), inflammatory bowel disease, microscopic colitis, and Clostridium difficile colitis. Smooth muscle structure and function, density of the interstitial cells of Cajal, and the health and function of the autonomic and enteric nerves of the colon are all potential affected by DM. These effects can in turn lead to alterations in colon motility, visceral sensation, immune function, endothelial function, and the colonic microbiome. The evaluation and treatment for slow transit constipation as well as pelvic floor dysfunction should be considered when constipation symptoms are refractory to initial treatment measures. DM-related medications and small bowel conditions such as celiac disease and small intestinal bowel overgrowth should be considered and excluded before a diagnosis of enteropathic diarrhea is made. Given the higher risk of CRC, adults with DM should be appropriately screened and may require a longer bowel preparation to ensure an adequate evaluation.


Diabetes Colon Slow transit constipation Diarrhea 


Compliance with ethical standards

Conflict of interest

Marc S. Piper declares that he has no conflict of interest.

Richard J. Saad acts as a consultant for Ironwood, Allergan, and Synergy pharmaceuticals.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Providence-Park HospitalMichigan State University College of Human MedicineLansingUSA
  2. 2.Michigan Medicine at the University of MichiganAnn ArborUSA

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