Diabetes and the gastrointestinal tract

Gastrointestinal (GI) complications of diabetes mellitus are common and substantially decrease health-related quality of life. Diabetes can affect every part of the GI tract, from the oesophagus to the rectum, and causes various symptoms, including reflux, heartburn, nausea, vomiting, abdominal pain, diarrhoea and constipation. Diabetes-induced GI complications are collectively referred to as diabetic gastroenteropathy. Over recent years, investigation of the underlying pathogenesis of diabetes-induced GI complications has provided objective evidence of abnormalities in the enteric nervous system, essential for normal motility within the GI tract. The diagnosis of diabetic gastroenteropathy is complex, and other causes of GI symptoms should be excluded. There is currently no cure for diabetic gastroenteropathy. Hence, treatment goals are to slow progression, relieve symptoms and manage complications. The key is tight glycaemic control, dietary advice and occasionally pharmacological treatment.