Diarrhea is one of the most unpleasant malfunctions that the body can experience. It does however have a purpose – usually to help the body to rid itself of waste, rapidly in liquid form, when there is a bacterial, viral or parasitic infection. There are other causes of diarrhea, and in the case of diabetes, some very specific reasons why diarrhea may present.
The many reasons you have the runs
If you’ve had a bout or several bouts of diarrhea, then you may know some of the other causes. They can include:
- Consuming too many sugar alcohols in too short a period of time (chewing many pieces of sugarless gum, for example)
- Consuming a food or drink containing lactose, when you are lactose intolerant
- Taking a medication whose side effect can be diarrhea (such as Metformin)
- Suffering with a disease like IBS (irritable bowel disease), Crohn’s disease or celiac disease
- Having a peptic ulcer or gall bladder disease
- Use of Orlistat for the treatment of obesity
- Food poisoning
- Antibiotic use, which can alter the delicate gut microbe balance
- Having autonomic neuropathy, as with diabetes
The diarrhea will often resolve quickly when it’s due to some of these causes. Chronic Type 1 or Type 2 diabetes can raise the risk of experiencing chronic, intermittent episodes of diarrhea. Of course, managing or limiting stress, changing a medication like Metformin, and ruling out celiac disease (patients with either type of diabetes have a higher risk for this condition), can help to limit diabetes-related diarrhea episodes. When diabetes-related diarrhea is specifically caused by autonomic neuropathy, it can be more of a challenge.
A complication from diabetes
Autonomic neuropathy occurs when there is damage to the nerves that control certain body functions. Many individuals are aware of peripheral neuropathy, which is often present in diabetes. In the case of individuals who suffer with long term chronic diabetes, a high number of patients present with intestinal complaints due to impaired nerves innervating the intestinal tract. This is largely due to the fact that diabetes can affect the digestive system, from the mouth all the way to the end point or anus. In longstanding diabetes, the enteric nerves supplying the small intestines can become impaired, affecting motility, secretion, or absorption of digestive by-products. This can lead to abdominal pain, bloating and diarrhea. The diarrhea bouts can be more frequent when Metformin medication or consumption of sugar alcohols occurs.
Identifying the cause of diarrhea
When a patient keeps a journal and tracks diet, medications, and bowel habits, it can help a clinician to determine the source of the diarrhea. The doctor will likely rule out a slew of possible causes, allowing him to hone in on the likely culprit. Journal entries should include when symptoms began, color, frequency and consistency of the stool, whether or not blood is seen, and whether or not nausea and vomiting are present. A stool sample will also help to identify a bacterial infection or parasite, or rule them out.
Treatment and specific diabetes considerations
It is crucial to stay hydrated during a mild, moderate or severe episode of diarrhea. A bland diet including water, tea, very dilute fruit juice, ginger ale, white toast, white rice, bananas and broth soups, will allow the intestinal track to use minimal energy for digestive purposes, which will aid in recovery. That means you want to avoid greasy and highly processed foods, gassy foods such as beans, and foods with natural sorbitol including prunes, milk products and caffeine. Taking probiotics to restore microbe balance in the gut may help during episodes of diarrhea, especially if diarrhea is caused by a regimen of antibiotic therapy.
Medications including Pepto-Bismol and Kaopectate used short term can help to limit the frequency of bowel movements during an episode of diarrhea. There are other medications that can be used to treat long-standing bouts of diabetes-related diarrhea. Sometimes antibiotics, oral clonidine and somatostatin analogues may have a role in treating diarrhea in the patient with diabetes.
A healthy, balanced diet rich in whole foods, regular exercise and stress reduction, and managing blood sugar levels effectively can help to minimize the risk of diabetes-related diarrhea.
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Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she’s been reporting and blogging on lifestyle issues and health news for over 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.