What's the connection between diabetes and darrhea?

No one wants to talk about diarrhea. More so, no one wants to experience it. Unfortunately, diarrhea is often the body's natural way of expelling waste in liquid form when a bacterial, parasitic, or viral infection is present.

However, there are other things that can cause diarrhea for everyone, and some things that can cause diarrhea specifically in those with diabetes.

Diabetes and diarrhea

There are various things that can cause diarrhea.

These include:

• Illness, such as bacterial or viral infection, or food poisoning
• Large amounts of sugar alcohols, such as sorbitol, that are often used in sugar-free products
• Taking lactose (milk sugar) when someone is lactose intolerant
• Some medications, such as metformin, a common medication used to treat diabetes
• Diseases such as irritable bowel syndrome, Crohn's disease, and celiac disease
• Autonomic neuropathy, a long-term complication of diabetes

In some cases, such as with illness or the use of sugar alcohols, diarrhea does not last for long. It tends to stop once the illness is over or the person stops using sugar alcohols.

With metformin, the symptoms can go away with time. Some people in whom the diarrhea does not resolve may need to stop taking the medication, however.

Bowel diseases may cause lasting problems for people with these conditions. Diarrhea and other symptoms can be managed or controlled with lifestyle changes such as stress reduction, and medications as needed. People with type 1 diabetes are at higher risk of celiac disease, and should check for this if long-term diarrhea is a problem for them.

A long-term complication associated with diabetes that can lead to long-term diarrhea (and constipation) is called autonomic neuropathy.

Autonomic neuropathy occurs when there is damage to the nerves that control how the body works. Autonomic neuropathy can affect the nerves that control all automatic bodily functions such as heart rate, sweating, and bowel function.

Since diabetes is the most common cause of autonomic neuropathy, people with long-term diabetes complications struggle with the effects the disease has on their nervous system.

Reports show as many as 75 percent of patients visiting diabetes clinics will report significant symptoms affecting the gut.

Diabetes can affect the entire gut, from the mouth to the anus. As a result, it's no wonder that people with diabetes can report higher instances of diarrhea.

Diagnosis

A doctor will diagnose diarrhea after reviewing the patient's medical history, symptoms, and length of time the problem has persisted. While every person's bowel movements are different, there are some clinical signs that indicate when a medical problem is present.

Symptoms sometimes seen with diarrhea include loss of appetite, bloating, nausea, vomiting, difficulty swallowing, and heartburn. These symptoms should be discussed with a physician, especially since they can lead to dehydration.

When speaking to a doctor, a patient should know:

• When the problem started
• What medications they are taking
• The frequency and consistency of their bowel movements
• If blood is present in their stool
• If nausea and vomiting are also present

When it comes to testing for and treating diarrhea, all the above conditions can contribute. People should keep a record of foods that may affect their condition.

Diarrhea may clear up on its own with time. However, a doctor may decide to run some tests in some cases. The decision to run tests is based on many factors. These factors include those listed below.

For cases of short-term diarrhea:

• Patient is very young or very old
• Signs of dehydration
• Blood or pus in stool
• Severe pain
• Patient has an impaired immune system
• Patient is recently hospitalized or taking antibiotics
• Patient has recently traveled abroad
• Diarrhea has lasted over 1 week

For cases of long-term diarrhea:

• Doctor suspects underlying cause of diarrhea
• Blood tests that show anemia and raised levels of platelets
• Liver is not working properly
• Problems with the thyroid, a gland in the neck
• Suspected irritable bowel syndrome
• Suspected celiac disease
• Doctor suspects the body is not absorbing nutrients properly - they may then test for the following nutrients:
• Calcium
• Vitamin B12
• Folate
• Iron
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Treatments for diarrhea

Treatment for diarrhea depends on the cause. If caused by illness, treatment involves letting the bacteria or parasite that caused the condition be eliminated from the body and allowing time to heal. Regardless of the cause, there are some standard treatments that people with diarrhea will benefit from.

The first step in treating any form of diarrhea is to drink water. Patients need to replace the lost fluids so that they do not become dehydrated. People with severe cases of diarrhea may need to be given fluids directly into their veins.

Other treatments include:

• Oral rehydration solutions - the World Health Organization report a 90 percent success rate in treating dehydration associated with diarrhea using salt and glucose pills.
• Over-the-counter medication - Imodium or Pepto-Bismol are examples of medicines that reduce stool and can be taken as soon as the first loose stool. They are also useful for travelers.
• Antibiotics - these prescription medications are needed for cases of diarrhea that have been caused by a bacterial infection.
• Probiotics that have been shown to help improve diarrhea.
• Diet changes - eating foods that are high in potassium like diluted fruit juices (avoiding added sugar), potatoes, and bananas. Salty foods such as broth, salted crackers, and sports drinks can also be useful.

Things to avoid:

• Fried and greasy foods
• Gassy foods, such as broccoli, beans, and prunes
• Sugar alcohols - these are used as substitutes for sugar in some products
• Milk (if intolerant to milk)
• Caffeine, alcohol, and fizzy drinks

Tips for preventing diarrhea

To prevent diarrhea from illness, follow a few simple steps:

• Drink clean water. This may be harder when traveling so travelers should understand the conditions of where they are and boil or buy bottled water.
• Wash hands with soap and warm water. This should always be done after touching public places, using the toilet, and helping a child use the toilet. Hands should also be washed before and after preparing food.
• Practice good hygiene.
• Use an antibacterial hand rub when soap and water cannot be used.

People with long-term diarrhea should track their symptoms and discuss them with the doctor so that they can determine the underlying cause.