Diarrhea: Causes and Self-Care Treatments

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Diarrhea in the Diabetes Patient

Patients with diabetes are more likely to experience gastrointestinal symptoms, including heartburn, nausea, vomiting, constipation, fecal incontinence and abdominal pain.

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The diabetes patient is especially prone to diarrhea. In one study, a diarrhea prevalence of 3.7% was documented in a group of 861 patients attending a primary care diabetes clinic.

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Type 1 diabetics were more likely to experience a true diabetic diarrhea, while diarrhea in type 2 patients was most commonly caused by metformin.

Why would true diabetic diarrhea be common in type 1 patients, and extremely uncommon in the type 2 patients? The likely answer lies in the greater magnitude of glucose swings experienced by type 1 diabetes patients. Through bowel biopsy, researchers explored the nature of small bowel microangiopathies in insulin-dependent diabetics.^[10] They uncovered evidence of prominent wall thickening and lumen narrowing in the duodenum caused by accumulation of hyaline, all presumably secondary to chronic hyperglycemia in poorly controlled type 1 diabetes.

Insulin-dependent diabetes patients are more likely than the general population to suffer from diarrhea caused by celiac diseases such as gluten-sensitive enteropathy.^[11] The diabetic is also more likely to experience diarrhea because of diet. Nonabsorbed artificial sweeteners such as sorbitol and xylitol are commonly found in diabetic candies and foods and may cause an osmotic diarrhea. However, sorbitol loads under 10 grams are less likely to be responsible. In one study, 10-20 grams of sorbitol was needed to cause mild discomfort and abdominal distension.^[12] Even then, diarrhea was uncommon. Therefore, perhaps xylitol is the more likely cause of the well-known "Halloween diarrhea" often experienced by children on November 1st.

Patient Information

Diarrhea: How to Treat it at Home

Many people have diarrhea each year. Most of the time, it lasts less than a day, and goes away without leaving any problems. However, occasionally, diarrhea can be far more serious and may be a sign of serious illness. For this reason, there are some guidelines on packages of nonprescription products that help you determine when you should seek the advice of a physician.