April 12, 2001
Question from Dolgoprudny, Russia:
I am 32 years old and have had type 1 diabetes for 17 years. I had hepatitis-B at the age of 18 and now I feel problems with my gallbladder which don' t get better with gall-stimulating pills. I also have problems with too much flatulence after starchy food, vegetables, fruits. It is very difficult to organize an appropriate meal plan as a result, and since I am a journalist, I cannot do my job with a muttering abdomen. I've visited doctors, done investigations of intestine and gall-bladder, even X-rays, but they found nothing that could cause such problems. Can it be because of autonomic neuropathy? What else can I do for my health?
Sometimes people with diabetes can have bacterial overgrowth problems within the intestine. The gut doesn’t move rapidly and bacteria set up and live in increased amounts in the intestine. When you eat a meal with fruits and vegetables, the bacteria metabolize the food and gas is produced. This can also be associated with diarrhea and loose stools.
There are also functional abnormalities associated with gastrointestinal discomfort and increased gas production, such as irritable bowel syndrome. These conditions require discussion with your physician so that a plan can be made regarding your treatment. It is possible to have neuropathy involving the gut. This generally involves nausea, vomiting small amounts of food, and delayed emptying of the stomach. It can also involve diabetic diarrhea if the motility is altered in the distal portion of the colon.
You might also have another condition which is not related to diabetes.