Management of chronic constipation in patients with diabetes mellitus

Prasad, V G Mohan; Abraham, Philip

doi:10.1007/s12664-016-0724-2

Cited by 48 publications

(48 citation statements)

References 113 publications

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“…When evaluating constipation in a diabetic, careful attention should be taken to review the medications as these may be contributors to the constipation [16, 22•, 23]. It should also be noted that anorectal disorders are prevalent in diabetics and can also contribute to constipation; as such, a careful rectal examination to screen for coexistent pelvic floor muscle dysfunction should be performed [23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…The first step in the treatment of mild constipation symptoms should include lifestyle modification such as increasing physical exercise and increased dietary fiber. Such lifestyle modification is generally recommended by the American Diabetes Association (ADA) to improve blood sugar management [22•]. The next therapeutic step should include the use of bulk, osmotic, or stimulatory laxatives.…”

Section: Treatment Considerations In Constipation (Table 1)mentioning

confidence: 99%

“…It has been suggested that lactulose may have an added effect at lowering blood glucose [26]. With that being said, bloating caused by lactulose can often be rate limiting [22•]. If colonic transit is either presumed or proven to be delayed, the osmotic and stimulatory laxatives would be preferred to increased dietary fiber and bulk laxatives.…”

Section: Treatment Considerations In Constipation (Table 1)mentioning

confidence: 99%

“…Indeed, one pilot study found prolonged colonic transit time in a group of 10 diabetics with constipation (compared to controls) [20]. In another study, diabetics with autonomic dysfunction (assessed by the sinus arrhythmia resulting from a single forced respiratory cycle) were more likely to have constipation than diabetics without autonomic dysfunction (22 vs 9%, p < 0.04) [21, 22•].…”

Section: Introductionmentioning

confidence: 99%

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Diabetes Mellitus and the Colon

Piper

Saad

2017

Curr Treat Options Gastro

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Opinion statement Diabetes mellitus (DM) can affect the structure and function of the colon promoting commonly encountered lower gastrointestinal symptoms such as constipation, diarrhea, abdominal distention, bloating, and abdominal pain. Specific colonic disorders for which adults with DM are at greater risk include chronic constipation, enteropathic diarrhea, colorectal cancer (CRC), inflammatory bowel disease, microscopic colitis, and Clostridium difficile colitis. Smooth muscle structure and function, density of the interstitial cells of Cajal, and the health and function of the autonomic and enteric nerves of the colon are all potential affected by DM. These effects can in turn lead to alterations in colon motility, visceral sensation, immune function, endothelial function, and the colonic microbiome. The evaluation and treatment for slow transit constipation as well as pelvic floor dysfunction should be considered when constipation symptoms are refractory to initial treatment measures. DM-related medications and small bowel conditions such as celiac disease and small intestinal bowel overgrowth should be considered and excluded before a diagnosis of enteropathic diarrhea is made. Given the higher risk of CRC, adults with DM should be appropriately screened and may require a longer bowel preparation to ensure an adequate evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Treatment Considerations In Constipation (Table 1)mentioning

confidence: 99%

Section: Treatment Considerations In Constipation (Table 1)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diabetes Mellitus and the Colon

Piper

Saad

2017

Curr Treat Options Gastro

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“…Constipation is one of the most common gastrointestinal symptoms in patients with diabetes 1 and occurs more frequently than in healthy individuals. Slow transit constipation, which is typically observed in diabetics and need to be controlled by proper diagnostics and treatment.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Alpha Glucosidase Inhibitor (Miglitol) for its Efficacy in Constipation Associated with Diabetes

Kumar¹,

Thakur²,

Goyal³

2019

IJPER

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Objectives:Recently, miglitol emerged as effective α-glucosidase inhibitor for the treatment of diabetic mellitus with specific advantages over currently available class of antidiabetic drugs. The aim of the present study was to evaluate the effects of miglitol in diabetes and associated constipation. Methods: Diabetes was induced in Wistar albino rat by streptozotocin given at dose of 25mg/kg, i.p. for 3 days consecutively to develop diabetes complications during next four weeks. The drugs were administered for 4 weeks starting from day 29 of post streptozotocin injections. Food and water intake, fecal parameters were measured on weekly basis. Gastrointestinal transit was monitored by charcoal meal and α-amylase activity was measured in all the treatment groups. Key findings: Treatment with miglitol demonstrated markedly increase in the gastrointestinal transit ratio in the diabetic rats and showed less α-amylase inhibitory activity, which providing evidences that miglitol does not exert constipation in the rats as compared to acarbose, which strongly inhibits the α-amylase enzyme and cause constipation in diabetic rats. Conclusion: These results suggest that miglitol has a potential to be used in the treatment of diabetes and associated constipation.

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Galacto-Oligosaccharides and Other Products Derived from Lactose

Otter

Jayasinghe³

2022

Advanced Dairy Chemistry

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Management of chronic constipation in patients with diabetes mellitus

Cited by 48 publications

References 113 publications

Diabetes Mellitus and the Colon

Diabetes Mellitus and the Colon

Evaluation of Alpha Glucosidase Inhibitor (Miglitol) for its Efficacy in Constipation Associated with Diabetes

Galacto-Oligosaccharides and Other Products Derived from Lactose

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