Type-1 Diabetes Patients with Chronic Constipation May Suffer from Defecatory Disorders

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USA: A recent study has found that patients with Type 1 diabetes (T1D) and chronic constipation (CC) may also suffer from defecatory disorders (DDs). The study was published in Neurogastroenterology and Motility Journal.

Chronic constipation is related to decreased rectal sensation and may be caused by defecatory diseases. The study, conducted by researchers at Mayo Clinic, Minnesota sought to compare complications of T1D, anorectal dysfunction, and CC symptoms, among T1DCC patients with versus without a DD.

The study measured anorectal pressures at rest and during squeeze and evacuation, as well as rectal sensation and rectal balloon expulsion time (BET) in 114 consecutive T1DCC patients.

The study concluded with the following key takeaways:

1. 37 patients (32%) had prolonged BET suggestive of a defecatory disorder (DD).

2. Complications of T1D included peripheral neuropathy (59%), retinopathy (37%), and nephropathy (23%).

3. Retinopathy was more prevalent in patients with normal BET (45%) than prolonged BET (19%).

4. Patients with prolonged BET had lower rectal pressure, greater anal pressure, and lower recto-anal gradient during evacuation compared to patients with normal BET.

5. Anal resting pressure and anal squeeze increment were below normal in 14 (13%) and 32 (29%) patients.

6. Abnormalities affected similar proportions in the normal and prolonged BET cohorts.

The study highlights the importance of diagnosing DDs in T1DCC patients with chronic constipation, as it may help in the management and treatment of their symptoms.

The researchers suggest that “Further studies should be conducted to better understand the relationship between T1D, chronic constipation, and defecatory disorders.”


Xiao A., Kathavarayan Ramu S., Gautam M., Bharucha A.; Defecatory disorders in patients with type 1 diabetes and chronic constipation; Neurogastroenterology and Motility; 2023 doi: https://doi.org/10.1111/nmo.14599

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