Terminal Colonic Dilation Following Intractable Diarrhea in a Diabetic

Paley, Ronald G.; Mitchell, Winifred; Watkinson, G.

doi:10.1016/s0016-5085(19)35119-4

Cited by 25 publications

(4 citation statements)

References 4 publications

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“…megacolon [152]. Measurement of rectal sphincter pressure showed no difference between normal subjects and diabetics, and loss of sphincter control was attributed to impaired sensory innervation [110].…”

Section: Gastrointestinal Systemmentioning

confidence: 87%

Diabetic autonomic neuropathy

1979

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This review attempts to outline the present understanding of diabetic autonomic neuropathy. The clinical features have been increasinly recognised but knowledge of the localization and morphology of the lesions and their pathogenesis remains fragmentary. A metabolic causation as postulated in somatic nerves accords best with clinical observations. Most bodily systems, particularly the cardiovascular, gastrointestinal and urogenital, are involved with added disturbances of thermoregulatory function and pupillary reflexes. Possible effects on neuroendocrine and peptidergic secretion and respiratory control await definition. Current interest centres around the development of a new generation of tests of autonomic nerve function that are simple, non-invasive, reproducible and allow precision in diagnosis and accurate quantitation. Most are based on cardiovascular reflexes and abnormality in them is assumed to reflect autonomic damage elsewhere. Probably no single test suffices and a battery of tests reflecting both parasympathetic and sympathetic function is preferable. Little is known of the natural history. The prevalence may be greater than previously suspected and although symptoms are mild in the majority, a few develop florid features. The relation of control and duration of diabetes to the onset and progression of autonomic neuropathy is not clearly established. Once tests of autonomic function become abnormal they usually remain abnormal. Symptomatic autonomic neuropathy carries a greatly increased mortality rate possibly due to indirect mechanisms such as renal failure and direct mechanisms such as cardio-resiratory arrest. Improved treatment of some of the more disabling symptoms has been possible in recent years.

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Section: Gastrointestinal Systemmentioning

confidence: 87%

Diabetic autonomic neuropathy

1979

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“…3 Occasionally, stercoral ulcerations have been reported in diabetes mellitus in association with colonic distension and subsequent mucosal erosion. 48 Like the other intestinal motor abnormalities, large bowel motility problems are usually seen in patients with associated peripheral neuropathies. 35 Treatment is basically symptomatic, with administration of laxatives and/or stool softeners.…”

Section: Large Intestinementioning

confidence: 99%

Gastrointestinal Manifestations of Diabetes Mellitus

1979

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This review briefly outlines the gastrointestinal manifestations of diabetes mellitus. Usually, gastrointestinal abnormalities are asymptomatic. Severe gastrointestinal dysfunction may be quite debilitating, however. Gastrointestinal symptoms that are a consequence of diabetes may be confused with other primary gastrointestinal disorders. We attempt to provide a clinical approach to differentiating the basis of symptoms and outline the therapeutic plan that we generally employ. Much additional research is necessary to clarify our understanding of the pathophysiology of the gastrointestinal complications of diabetes and to develop improved therapeutic strategies.

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“…Although blood in the stools has been attributed to diabetic diarrhoea this symptom makes a fresh search for another cause essential. Colonic distension occasionally occurs and may present as a surgical emergency (Paley et al 1961).…”

mentioning

confidence: 99%

Diabetic Diarrhoea

Knapp

1966

Proceedings of the Royal Society of Medicine

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Terminal Colonic Dilation Following Intractable Diarrhea in a Diabetic

Cited by 25 publications

References 4 publications

Diabetic autonomic neuropathy

Diabetic autonomic neuropathy

Gastrointestinal Manifestations of Diabetes Mellitus

Diabetic Diarrhoea

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