Living with diabetes means paying careful attention to all the body systems, because the disease can affect any organ. The gastrointestinal tract is not an exception. It has been estimated that up to 60% of diabetes patients suffer from constipation. This is because high blood sugar has a negative effect on nerve fibers, which affects:
- The autonomic nervous system leading to GIT dysfunction
- Slower emptying rate
- Poor nutrient absorption
- Contractile colon muscle function and bowel motility
- Anal sphincter dysfunction.
Poor long-term blood sugar control can lead to all these disorders happen simultaneously, though very rarely. In most cases intestinal issues appear when one or several of the above-listed dysfunctions are present.
In the early stages of diabetes, when the patient hasn’t learnt about their medical problem yet, constipation occurs due to unhealthy diet. But as soon as the diet is improved, bowel movement restores on its own.
Constipation in diabetes can be both chronic and occasional. It can appear even with proper diet and water schedule. The reasons for this are:
- People with diabetes are prone to losing fluids quickly, and dehydration is known to cause constipation
- High blood sugar levels caused by type 1 and type 2 diabetes negatively affect nerve transmission resulting diabetic neuropathy.
- Damage to the nerves controlling the digestive tract impairs bowel activity leading to constipation, diarrhea and incontinence.
- Diabetes hinders blood circulation which deprives lower GIT of enough arterial blood and leads to constipation.
- Diabetes is always accompanied by endocrine disorders, which is a common factor for sluggish intestinal motility .
- Medications for diabetes can sometimes slow down intestinal motility and cause constipation.
Chronic constipation is one of the long-term complications of diabetes and it develops in people who have lived with diabetes for many years. In this case constipation can be:
- Primary – problems with bowel emptying had developed prior to diabetes and grew worse after diabetes manifestation.
- Secondary – persistent hyperglycemia is the main factor to provoke fecal impaction.
- Tertiary – worsening of intestinal peristalsis and GIT organs is associated with regular long-term intake of various medications.
Although causes of constipation can be different, the symptoms are the same. The above-listed classification has its peculiarities concerning restoration of natural bowel movements, therefore treatment should be prescribed by the doctor.
The basic therapy for constipation is a healthy diabetes diet, which includes sugar-reducing foods and products that improve bowel movement, drinking more water and increasing physical activity. Increase insoluble fiber in your dietary regimen and include more raw or cooked vegetables, boiled beetroot, stewed pumpkin, flax seeds and leafy greens. All of these can help the GI tract function more smoothly.
If natural solutions do not bring improvement and there are big underlying problems, talk to your doctor about moving on to medications.
Medications, such as laxatives, may provide relief but are not intended for a long-term use. They are good for immediate relief of short-term constipation, but if used regularly they may cause dehydration and electrolyte imbalance. Moreover, when used continuously, most laxatives can cause habituation effect, which aggravates bowel movement problem and can result in complete refusal of intestine to work on its own.
Stool softeners have a milder action as they work on the stool, not the intestine, and help it get wet and soft. They are gentle enough to prevent constipation with regular use and are good for people with mild chronic constipation.
In most cases proper blood sugar control is the best solution for regulating bowel movement in diabetes as it prevents nerve damage that can result in constipation, no matter your diet or activity level.
In any case, constipation in diabetes is not so easy to treat and only your doctor can find the least intensive treatment to alleviate your condition.