Diabetic enteropathy is not a very common condition that complicates diabetes. The essence of this disease lies in the fact that the functional activity of the intestine is disturbed against the background of the primary lesion of the nervous system, namely, the department that innervates the digestive tract. From a clinical point of view, this pathology is accompanied by severe problems with the chair. Diabetic enteropathy has a relatively favorable prognosis. Properly selected therapy allows you to quickly cope with this complication. Most often, this pathological process does not lead to any serious consequences. However, sometimes it can cause water and electrolyte disorders.
Despite its name, diabetic enteropathy implies a defeat not only of the small intestine, but also of the fat one. For the first time, diabetes mellitus, accompanied by a disorder in the stool, was described as early as nineteen twenty-six. In 1949, it was possible to establish that the basis of the development of this disease is primary diabetic neuropathy. According to statistics, this complication occurs in approximately one case per hundred people suffering from hyperglycemia. It was noted that most people with diabetes of the first type, whose average age is from thirty-five to forty-five years, are faced with this disease.
Despite the fact that diabetes is more often diagnosed among women, the occurrence of diabetic enteropathy is more susceptible to men. In this case, a prerequisite is a long experience of the DM. On average, such a complication develops eight or nine years after the onset of the disease.Another important predisposing factor is long-term intractable hyperglycemia, contributing to an even greater increase in dysmetabolic disorders.
At risk for the development of this disease are people with concomitant problems with lipid metabolism. Here we mean those patients who have elevated blood lipids. Overweight is also among the predisposing factors. Bad habits and a systematic increase in blood pressure – all this increases the likelihood of such complications.
Separately, it should be said that with sugar diabetes often there is a decrease in the level of immune protection. Against this background, there is an active reproduction of conditionally pathogenic flora, which also provokes problems with the digestive system.
As we have already said, the leading role in the development of diabetic enteropathy is assigned to the primary lesion of the peripheral nervous system. Nerve fibers and ganglia on the background of diabetes mellitus undergo degenerative changes, while small vessels and intestinal mucosa remain intact. There is a violation of the innervation of the intestinal wall, which leads to inhibition of motility. Similar changes occur in the biliary system, due to which bile ceases to enter the intestine in a timely manner. Against the background of ongoing processes, the absorption of water decreases, and its secretion increases. Conditionally pathogenic flora begins to actively multiply, which leads to damage to the intestinal wall. The result of all the above violations becomes osmotic diarrhea and the appearance in the fecal masses of excess fat.
Symptoms of diabetic enteropathy
An important feature of this disease is that the accompanying symptoms have a wave-like character and then they become aggravated, then they again subside. The duration of the acute period can be different and sometimes reaches several months. However, even during remission, some clinical manifestations are still present, although they have a weak degree of severity.
The main symptom of diabetic enteropathy is diarrhea. The stool becomes liquid and in case of a severe course it can reach up to thirty times a day. Directly fecal masses have a brown color and an oily consistency due to the high content of fat in them. It is interesting that at night there is an increase in the urge to act to defecate, and sometimes the intestines are spontaneously emptied. Another characteristic complaint is a complaint of painful false urges to the act of defecation.
Sometimes, with a complicated course of this pathological process, symptoms such as nausea and vomiting, abdominal distention and soreness, aggravated after eating, join. In the event that, against the background of long-term diabetic enteropathy, there are problems with the absorption of nutrients, there is a decrease in body weight. Sometimes the clinical picture is supplemented by disorders of the stomach or esophagus.
Diagnosis and treatment of the disease
First of all, the diagnosis of this disease is based on the diabetes history. It is imperative to find out how long the patient has been given such a diagnosis, whether he observes the doctor’s recommendations, and so on. From instrumental methods of research, contrast radiography, endoscopic examination or computed tomography are shown. It is also recommended to conduct a coprogram.
For the treatment of diabetes mellitus enteropathy, it is initially necessary to normalize glucose levels. Patients are assigned vitamins from group B, which have a beneficial effect on the nervous system. Also from drugs used alpha lipoic acid, which normalizes metabolic processes in the peripheral nervous system. The rest of therapy is aimed at stopping diarrhea. It includes the means to reduce intestinal motility, alpha2-adrenoreceptor stimulants, and so on. Suspected bacterial infection is indicated. antibiotics.
Prevention of such complications in diabetes mellitus
The main method prophylaxis is compliance with all the recommendations of the doctor regarding diet and drug therapy for diabetes.