Effectiveness of Aldose Reductase Inhibitors for Diabetic Gastroenteropathy with Constipation.

Abstract

Wepresent a diabetic patient with long-standing constipation complicated by paralytic ileus and septic shock. Shesuccessfully recovered from a critical condition, and her diabetes was well controlled. However,the constipation did not improve even after the administration of conventional medications. Epalrestat, an aldose reductase inhibitor (ARI), improved her bowel motility and autonomic cardiovascular dysfunction, as evident from her heart rate and blood pressure response. Gastroenteropathy is a major diabetic complication which maycause disturbed bowel motility leading to serious enterobacterial infections, thus, its amelioration is important. ARI may be beneficial in the treatment of diabetic gastroenteropathy refractory to conventional therapies.

Pathophysiology in Diabetic Patients with Fecal Incontinence

“…Jaspan et al 17) reported that ARI had an effect on both autonomic and somatic nerves. Nakamura at al 18) reported the effectiveness of ARI in the treatment of constipation in cases with diabetic gastroenteropathy.…”