Diabetes and IBS: What is the Connection?

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If you are the 10 percent of Americans living with diabetes, chances are you have gastrointestinal problems too. In fact, studies have shown that people with diabetes have many more digestive problems than the general population. Managing gastrointestinal side effects can be challenging – after all, it’s overwhelming enough to constantly monitor your diabetes without throwing digestive issues into the mix. There is hope, however. Practices such as diet, exercise, and stress relief can relieve gastrointestinal discomfort and help you manage your diabetes. Read on to better understand how diabetes affects your digestion and what techniques you can use to reduce stomach problems without increasing your blood sugar.

IBS and Diabetes

Although diabetes and gastrointestinal problems may seem like two separate problems, 75% of people with diabetes also have stomach and / or digestive problems. In addition, a study conducted by the University of Sydney found that gastrointestinal problems were “significantly more common” in diabetics when measured in non-diabetic controls.

Part of this prevalence could be due to irritable bowel syndrome, a condition that relates to a group of symptoms including abdominal pain and changes in bowel movements that occur at least one day a week. While IBS is not related to diabetes, it affects a significant ten to fifteen percent of the US population. Hence, there is a chance that someone with diabetes could also have IBS. There isn’t a single tool that doctors use to diagnose IBS. So, if you have symptoms compatible with IBS, your doctor will order a full medical history to rule out other conditions. It is important to note that, unlike other gastrointestinal diseases, IBS does not cause physical damage to the intestines or digestive system. In fact, the digestive tract remains free of any signs of damage.

Gastroparesis and diabetes

While it’s not entirely impossible that you could have both IBS and diabetes, Dr. Elliot Rayfield, clinical professor of medicine in Endocrinology, Diabetes, and Bone Diseases at Mount Sinai, suggests that it is far more likely that you may experience a more serious condition called gastroparesis. Gastroparesis, caused by high blood sugar, affects the speed at which the muscles in your stomach move food and, unlike IBS, can damage the gastrointestinal tract. “Many of the complications of diabetes in the various organs are related to the fact that the blood sugar is high, which can damage the nerves in the various organs,” notes Dr. Rayfield. “When the nerves in the GI tract are damaged, gastric emptying is impaired.” As a result, food moves slowly down the tract, which can cause people to feel full after just eating a small amount of food. Other symptoms include stomach pain, vomiting, and diarrhea. “Diabetics can get diarrhea because bacteria can overgrow in the GI tract due to a lack of exercise,” explains Dr. Rayfield. “This condition – called diabetic diarrhea – can be treated with antibiotics.”

In addition to the unpleasant side effects, gastroparesis can also be dangerous. People with severe gastroparesis can be malnourished because the intestines are unable to take in essential vitamins and nutrients from food. If you get full prematurely, the small amount of food you eat may not be enough to fully fill your body.

Diagnosis of gastroparesis

To diagnose gastroparesis, a doctor rules out IBS and other gastrointestinal diseases by performing “gastric emptying tests”. The most important test is called scintigraphy, in which the patient eats a meal that contains a small amount of radioactive material. An instrument that measures radioactive material is then placed over the stomach, which can measure the speed at which the food is moving. Other tests, such as an ultrasound and a breath test (which measures the amount of a substance in your breath that your body can absorb) can be used to diagnose gastroparesis.

What can help

Treating gastrointestinal problems and diabetes can be a delicate dance. Diabetics should incorporate high-fiber foods such as whole grains, vegetables and beans to stabilize blood sugar. Conversely, conventional wisdom dictates that those suffering from digestive problems such as diarrhea limit fiber consumption. What to do if you have both Contrary to popular belief, fiber can relieve symptoms of gastrointestinal discomfort, but it is important to look out for what. It has been found that incorporating soluble fiber (like flea seeds) into it can tighten stool and reduce gas. You can alleviate gastrointestinal problems while lowering blood sugar by eating a range of vegetables and legumes while avoiding hard-to-digest ones like beans and raw broccoli.

Dr. Rayfield advises that those with stomach problems and diabetes change their eating habits. “It’s better to eat small, frequent meals, stay well hydrated, and have continuous glucose monitoring,” he says. If you’re still suffering, he suggests asking your doctor about medications such as Reglan (metoclopramide), which are prescribed to treat vomiting, loss of appetite, and premature fullness.

Inclusion of exercise and stress management

A sedentary lifestyle can make gastrointestinal problems and diabetes worse. Research has shown that a walk after a meal – more formally known as a “postprandial walk” – can be helpful for diabetics because light exercise helps control blood sugar levels and limits gastrointestinal problems like diarrhea. Exercise in general promotes gastric emptying, which relieves symptoms of gastroparesis.

Stress management also plays a major role. Anxiety can affect how quickly food moves through the digestive tract and cause painful muscle spasms. It can also affect the level of absorption of the nutrients in the foods you eat, which can exacerbate the malabsorption problems associated with gastroparesis. While stress can’t cause diabetes, it can release hormones like cortisol and adrenaline, both of which disrupt the normal functioning of insulin and raise blood sugar levels. All of this can put you at risk for more serious complications.

You can manage your stress levels by using certain techniques that have been shown to calm an anxious mind and bowels. Practices like mindfulness meditation and exercises like yoga and qigong have been shown to reduce stress and promote relaxation.

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