You probably know that diabetes puts you at higher risk for health problems like heart disease and obesity, but you may be surprised to learn that it can also cause problems in your gut and other areas of your gastrointestinal (GI) tract.
Uncontrolled blood sugar damages your nerves, and that includes the nerves in your stomach and intestines. In fact, people who have diabetes often have GI problems.
Constipation is one of the most common symptoms, but there are others. It’s a good idea to be on the lookout for them so your doctor can help you to get them under control. Here are some of the most common gut-related conditions for people with diabetes.
Gastroparesis
A major nerve in your GI tract (called the vagus) signals muscles to push food from your stomach to the small intestine. If diabetes damages this nerve, the food you eat slows down or stops on its way from the stomach to the small intestine. This is called gastroparesis (or delayed gastric emptying). It’s more common in women than men.
Symptoms include:
- Feeling full after just a few bites of food
- Stomach bloating or discomfort after a meal
- Throwing up, or feeling like you’re going to throw up
- Upper stomach pain
Sometimes gastroparesis makes it difficult to control your blood sugar levels. That might be your first sign that you have the disorder.
There are several treatments for this condition. If it’s a mild case, just changing your diet can ease your symptoms. If that doesn’t work, medicines might. In severe cases, your doctor might have to place a stimulator inside your stomach to make its muscles work better.
Diabetic Enteropathy
Enteropathy means disease of the intestine. You’re more likely to have it if you have gastroparesis. If you’ve had diabetes for a long time, you might also have problems with your small intestine, colon, or rectum.
Diabetes-related damage to nerves in the intestines causes the food you eat to slow down or stop as your body processes it. That leads to constipation, and creates a breeding ground for unhealthy bacteria. As a result, you might have diarrhea (or a combination or constipation/diarrhea, which is the most common symptom of enteropathy).
Stool might leak from your rectum, and you may find it hard to control bowel movements. The problem may get worse after you eat.
Your doctor will probably want to rule out other possible causes of your problem, like diet, medications, or diseases such as a thyroid disorder.
If you have diabetic enteropathy, your doctor will try to find ways to help keep your blood sugar stable and control your symptoms.
Nonalcoholic Fatty Liver Disease
This is the buildup of fat cells in the liver of people who drink little or no alcohol. It looks a lot like liver damage seen in people with alcoholism. You’re at risk for it if you have diabetes or obesity.
If you have nonalcoholic fatty liver disease, you’ll find it hard to control your diabetes. That’s because the more fat you have in your liver, the harder it is for your body to use and react to insulin.
Most patients with this condition don’t have symptoms. If you do, you may just feel tired or have tenderness in the right upper side of your stomach. The first sign is usually a rise on a blood test called ALT, which checks your liver function.
There’s no specific treatment for nonalcoholic fatty liver disease. But your doctor may recommend you keep your blood sugar under control, and they may suggest you lose weight. Or, they might prescribe medication to help your body better use insulin.
Other Ways Diabetes Affects the GI Tract
It can cause upper GI problems. Nerve issues in the esophagus may cause heartburn and make it hard for you to swallow. Your doctor will tell you what range you should keep your blood sugar in so you can control these symptoms. They might also prescribe or suggest antacids and the amount you should take.
Other GI diseases that are more common in people with diabetes include:
- Hepatitis C (infection of the liver)
- Cirrhosis (scarring of the liver)
- Hemochromatosis (iron buildup that leads to liver damage)
Always see your doctor if you have gut problems that are new or just won’t go away.
