Fibreoptic colonoscopic study of diabetic patients with lower gastro-intestinal disturbances

ABSTRACT

Fifteen patients with long standing diabetes mellitus with clinical manifestations of autonomic neuropathy and 10 without autoncmic neuropathy. All of them were complaining of lower gastrointestinal symptoms. Patients with parasitic infestation were excluded. Barium enema and fibreoptic colonoscopic examination with biopsies taken for histopathology and histochemical study were done. Results revealed constipation in 80%, diabetic diarrhea in 60%, irregular bowel habit in 40% and faecal incontinence in 20% of patients with autonomic disturbances radiological results showed spastic descending colon with loss of haustration in 30% of cases. Endoscopically, the lumen of descending colon was narrow and spastic in 50% who complained of constipation and irregular bowel habit. Oilated in 10% who had diabetic diarrhea. Hyperaemic mucosa and increased vascular pattern in 80%. Mainly in patients with diarrhea while erosion and bleeding on touch occurred only in 10% of cases. Fine granulations of mucosa up to the sigmoid were found in 30%. The histopathological pattern of nonspecific colitis. Congestion, different degree of cellular infiltrations - in 60% and superficial ulceration in 10%. Histochemical study showed increased activity of acid phosphatase enzyme in patients with erosions and hyperaemic congested mucosa. There was an observed relation between the degree of autonomic disturbances and the severity but not the duration of gastrointestinal symptoms, this may be attributed to disturbed colonic motor functions and susceptibility of diabetics to infection