Diabetes, also known by its full name, diabetes mellitus, is a disease in which your blood glucose levels are too high, yet your body is not using enough of the glucose. Glucose is important because it is the main "fuel" used by muscle and tissue cells, as well as by the brain. Because of diabetes' affect on many organ systems, people who have diabetes may be more likely to suffer from certain disorders of the gastrointestinal, or GI, tract.
Diabetes Overview
In most people, the rise in your blood glucose level after meals triggers the pancreas to produce more insulin in order to help the body absorb glucose. However, in diabetics; either the insulin is not produced or the body cannot use it properly, so the blood sugar levels remain high while the brain clamors for more fuel.
If diabetes is not well-controlled, your body can suffer damage from the high levels of glucose in your blood, according to the National Institutes of Health. People with uncontrolled diabetes can suffer from neuropathy, or nerve degeneration; damage to the eyes and kidneys; heart disease and stroke; and even circulatory issues so severe that sometimes limbs need to be removed.
Gastroparesis in Diabetics
Gastroparesis is a disorder in which the stomach takes longer than it should to empty into the small intestine, causing discomfort, bloating, nausea, vomiting and even spasms of the stomach muscles. The National Digestive Diseases Information Clearinghouse states that gastroparesis is more prevalent in diabetics because having overall high blood sugar levels can contribute to damaging the vagus nerve, the nerve responsible for moving food through the stomach and digestive tract.
Gastroparesis is a concern because of both the danger of food fermenting in the stomach and causing bacterial overgrowth, and the fact that it makes controlling blood glucose levels even more complicated. If you are diagnosed with gastroparesis, you will probably be put on a medication regimen and special eating plan. In some cases, people with gastroparesis need a feeding tube or other more extreme treatments.
Ulcers and Candida in Diabetics
James D. Wolosin, MD, FACP, and Steven V. Edelman, MD wrote in "Clinical Diabetes" that patients who have not had good control over their glucose levels risk contracting candida, or yeast, infections in their GI tracts. Oral candida, or thrush, can occur on the tongue and spread to the esophagus, and eventually cause intestinal bleeding, heartburn and trouble swallowing. Yeast infections of this type are generally treated using anti-fungal medications.
While some GI issues are more common in diabetics, Wolosin and Edelman say that peptic ulcers are not. Caused by the bacteria Helicobacter pylori, duodenal and gastric ulcers are treated in both diabetics and non-diabetics by an antibiotic and anti-gastric acid secretion regimen of medication.
The Small Intestines in Diabetics
Because of the overall danger of neuropathy in diabetics, the small intestines can be affected by diabetes as well due to their reliance on the enteric nerves to control absorption and secretion. Much like the problems associated with gastroparesis, partially digested food pooling in the small intestines can lead to bacterial overgrowth, which in turn can cause pain, bloating and diarrhea. The bacterial overgrowth usually responds to antibiotic regimens, but the neuropathy can be more complicated to treat, sometimes requiring antidepressants and even narcotics to manage the pain.
Celiac disease, or celiac sprue, is more common in people with diabetes. Celiac sprue is an allergy to wheat gluten that can cause inflammation of the small intestine and make absorbing nutrients more difficult. It is treated by avoiding gluten.
