Gastrointestinal Disorders

Abstract

Gastrointestinal symptoms are common among diabetic patients (1), although this is also true for the general population. In fact, it is not established by appropriate population studies whether the prevalence of gastrointestinal symptoms in diabetic patients is actually increased. What is clear is that a segment of the diabetic population presents gastrointestinal symptoms that can be related to specific physiologic gut dysfunctions. Interestingly, some diabetic patients without gastrointestinal symptoms may sometimes evidence physiological abnormalities (such as gastric stasis or anorectal dysfunction) at the subclinical level (2). One reason why it is so difficult to ascertain whether diabetic patients have more symptoms referable to the digestive tract than the general population is because the nature of the symptomatology, which coincides with that of individuals with common functional-type abdominal disorders. Only when gastrointestinal symptoms in a diabetic can be attached to a specific physiological abnormality caused by neuromuscular dysfunction is the clinician reasonably certain that he or she is dealing with a gut diabetic syndrome. Unfortunately this is not usually the case for most diabetic patients complaining about gastrointestinal symptoms in whom the relation between the diabetes and their digestive ailment remains presumptive at best, since physiological studies are only undertaken in patients with severe and disabling symptoms. Clinicians should, therefore, refrain from ascribing digestive symptoms to diabetes without further evidence than simple association.