I am a 41 year old male, wh has had type�1 for 15-20 years. For the past one to two years, I have been having nocturnal fecal incontinence on a frequent basis. It doesn’t occur every night, but regularly. My endocrinologist says it’s probably diabetic diarrhea. What actually causes it? What I can expect in terms of fixing it?

Diabetic diarrhea is part of a larger group of problems with the autonomic nervous system. The autonomic nervous system is responsible for housekeeping processes such as heart rate, breathing rate, bladder emptying, and digestion. It is also referred to as the “automatic” nervous system. However, it can become disrupted or involved, like other nerves in the body, when diabetes is present for a long duration of time.

Diabetic diarrhea is particularly disruptive to your lifestyle because of the difficulty of losing continence of your stool. The nerves responsible for sensing the buildup of pressure in the lumen of the gut are affected and there is not appropriate motility of fecal material. When the feces gets to the rectum, their is an uncontrolled or uncoordinated loss of normal sphincter tone to cause the loss of continence. However, there are treatments which help. You need to discuss these treatments with your physician. In addition, I would recommend you discuss with your physician a screening for other autonomic neuropathy problems.

JTL