Common Health Issues

Constipation and Abdominal Pain from Diabetes

• By Rich Health Editorial Team
• November 07, 2021

Any time you have fewer than three bowel movements a week, you have constipation. Constipation is probably the most common Gastrointestinal complication of diabetes. It affects 25% of all people with diabetes and more than half of people with neuropathy.

 

Constipation can have many causes. Most commonly, people with neuropathy develop constipation because the fecal waste moves so slowly through the GI tract that too much water is absorbed. This makes the feces hard and difficult to pass. It can also be caused by some sort of obstruction at the rectum, such as a rectal sphincter muscle that is not functioning properly. This may be due to damage to the nerves that control the sphincter. 

 

Also, poorly functioning pelvic muscles can also contribute to constipation, because you need to contract your pelvic muscles in order to have a bowel movement. Fortunately, there are many noninvasive treatments available that can alleviate the symptoms of this sometimes painful condition.

 

DIABETES CONSTIPATION SYMPTOMS

The primary symptom of constipation is the inability to have regular bowel movements. If you have fewer than three movements a week, or every other day, you are probably constipated. Not everyone keeps track of the timing of their bowel movements, but if you infrequently pass a stool and find that the stool is hard and that you have to strain to pass it, you probably have constipation. Sometimes you may even have to bend over or assume a contorted position to eliminate the stool. You may also have rectal discomfort and have a sense that you have not completely eliminated your feces. Bouts of constipation may alternate episodes of diarrhea.

 

What You Should Do When You Have Diabetes Constipation

Constipation is not necessarily an emergency situation although it can become quite uncomfortable and the symptoms can worsen the longer it goes on. The longer you wait to defecate, the more difficult it can be. If you are constipated, talk to your doctor about how best to treat it. In the meantime, you can try several self-help measures to see if they alleviate the problem.

 

Try drinking plenty of water during the course of the day, particularly during hot weather. Eight glasses a day is a good rule of thumb. Also, regular exercise can stimulate the bowels into action. Go for a walk or jog, or take a bike ride, or try any other activity that you like to do. Just keep moving. If you sweat excessively, drink plenty of water before and after you exercise. Eating also helps intestinal movement, so be aware of any urges, no matter how slight, after a meal.

You should try to eat 20 to 35 grams of fiber each day. If you are not doing so already, try increasing your fiber intake. However, this may not be advised if you have gastroparesis. You can incorporate fiber into your diet by eating more fruits, vegetables, legumes such as beans, peas and lentils and whole grains. You are better off trying to change your diet, before trying medications to loosen your stools.

 

If your dietary changes do not help, ask your doctor about over-the-counter medications. Stool softeners or psyllium (a fiber supplement) may be effective, especially in combination with other self-help methods such as diet and exercise. However, be careful about doing too much too soon. If you eat too much fiber (more than 35 grams a day), you may find that your symptoms of constipation worsen and that your plagued with flatulence (intestinal gas). Try increasing the fiber in your diet gradually. Talk to your doctor before using any laxative, especially if you have diabetes. Your body may start to depend on laxative and you may lose the ability to eliminate the waste on your own.

 

DIABETES CONSTIPATION TREATMENT

If your constipation persists, even when you change your diet and increase your activity level, talk to your doctor. She may want to conduct an examination of your rectum. This can be done using proctosigmoidoscopy. This device consists of a long tube with a light on the end that allows your doctor to look into your rectum and intestines. You may also be given a barium enema. This is an X ray of your intestines after you have been given an enema that contains barium, a soft metal that is opaque to an X ray. The barium will show up any blockages. Your doctor may also want to conduct a colonscopy to examine the lining of your colon.

 

Your doctor will also check to see if the mucous membranes of your colon and rectum look normal. She will also evaluate your muscles to see how efficient they are at eliminating stool during a simple rectal exam. You may also be evaluated to see if your pelvic muscles and the nerves supplying the muscles of the anus and rectum are functioning properly. If pelvic nerves and muscles are normal, then you doctor may use an X ray or gamma camera to measure how fast solid matter moves through your colon.

 

Depending on the results of these tests, your doctor may prescribe one of several medications to improve your bowel movements. Your doctor may suggest including fiber or laxatives, such as milk of magnesia, as part of your diet. Regular enemas may also be in order. Your doctor may also recommend a drug that increases colonic motility, such as bisacodyl (Dulcolax), a drug called cisapride, or a glycerin suppository.

 

DIABETES CONSTIPATION PREVENTION

To prevent constipation, eat a balanced diet with plenty of fruits, vegetable, and fiber, exercise regularly and drink plenty of water. Avoid the overuse of anti-diarrheal medications. For long-term prevention of the neuropathy that may cause constipation, do your best to keep your blood glucose levels as close to normal as possible. 

 

DIABETES ABDOMINAL PAIN

Almost everyone develops some sort of abdominal pain from time to time. And people with diabetes may suffer from the same problems as the rest of the population. But if you do have diabetes, you may be more likely to develop gallbladder disease, and this can contribute to abdominal pain. This may be because neuropathy affects the way the gallbladder functions. The gallbladder stores bile from the liver and releases bile to aid digestion. But if you have neuropathy, the gallbladder may have a difficult time contracting efficiently. As a result, bile pools in the gallbladder and forms a sort of sludge. Ultimately, the sludge forms stones. When the gallbladder attempts to push bile out, the stones get in the way and can cause pain.

 

Abdominal pain can also be caused by impaired circulation to the intestines, caused by atherosclerosis of the blood vessels that supply the abdomen. Damage to the nerves of the midsection can also cause abdominal pain.

 

DIABETES ABDOMINAL PAIN SYMPTOMS

Symptoms of gallstones include pain in the upper abdomen. It may come in waves and be particularly acute in the upper abdomen. Pain may get worse after a meal or in the middle of the night. You may also experience nausea or vomiting.

 

You may also feel pain in the girdle area if you have diabetic radiculopathy. This is caused by damage to the nerves that conduct impulses to the chest and abdomen. Gastroparesis and circulatory problems may also result in abdominal pain.

 

What You Should Do

Talk to your doctor if you experience any kind of abdominal pain. Abdominal pain can have many causes, which may or may not be related to diabetes. If your pain is severe or debilitating, call your doctor or seek emergency help. If your doctor suspects gallstone, she will probably examine you by an X ray called cholecystogram. Your doctor may also take blood for a blood analysis. Sometimes an ultrasound or computed tomography (CT) scan will also reveal gallstones.

 

 

DIABETES ABDOMINAL PAIN TREATMENT

If your tests show that your pain is due to gallstones, your doctor may recommend surgery. In the past, this operation was performed under general anesthesia in a hospital or clinic. The surgeon made a small incision in the upper abdomen and removed the gallbladder and any stones in the bile duct. The procedure usually took about 1.5 hours. Ask your doctor about newer techniques for gallbladder and stone removal involving a laparoscope.

 

DIABETES ABDOMINAL PAIN PREVENTION

To prevent gallstones, eat a balanced diet. Avoid foods that are high in fat or bring on pain or indigestion. To avoid neuropathy that may trigger gallstone development, keep your blood glucose levels as close to normal as possible over the long term

 

Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

Management of Chronic Constipation in Patients with Diabetes Mellitus by Philip Abraham and V G M Prasad

Abdominal Pain in Patients with Hyperglycemic Crises by G Umpierrez and A Freire