Desang diabetes magazine guide to common digestive disorders

LIVING

Gut feeling?

A guide to common digestive disorders, by

Judith Ozkan.

Many people know that diabetes can cause

nerve damage (neuropathy) and a loss of

feeling in the feet or legs. Less well-known

is that diabetic autonomic neuropathy

(DAN) which causes loss of sensation in the nerves

of internal organs has a wide range of effects on the

digestive system.

It's estimated that up to 75 % of people with diabetes

experience some sort of digestive disorder affecting the

gastro-intestinal (GI) tract which runs from the mouth to

the anus and is made up of major organs and small and

large intestines. Not all GI disorders are caused by nerve

damage from high blood sugars, some may be genetic,

or the side effect of medication. Let's take a look at some

of the main GI issues linked to diabetes and how to

treat them.

BAM/BAD

Bile acids are made in the liver, stored in the gallbladder,

and released into the small intestine (gut) to breakdown

food and absorb fats and vitamins. These acids also

remove waste products and most of them (97%) get

reabsorbed and returned to the liver in a permanent

cycle. If this cycle is disrupted it can result in bile

acid malabsorption (BAM) - also known as bile salt

malabsorption or bile acid diarrhoea (BAD). This can be

caused by diseases such as Crohn's, could be linked to

diabetic neuropathy (nerve damage) and also by some

medicines, including metformin.

Symptoms include frequent diarrhoea and stomach

problems like bloating, cramping and excessive wind.

Diagnosis of bile acid malabsorption requires a SeHCAT

(75Se-homocholic acid taurine) scan where you swallow

artificial bile acid to assess whether malabsorption is

taking place.

Treatment includes sticking to a low-fat diet and

medications which work by binding the bile acids

together in the small intestine to prevent irritation in the

large intestine.