I have lived with diabetes for more than 10 years and have kept it under control using medication. However, for the past two months, I have been experiencing continuous diarrhoea that has not improved, even after taking strong antibiotics such as Clavulin. What could be the cause, and what should I do? Magino
Dear Magino,
Diarrhoea refers to the frequent passage of loose, watery stool, usually three or more times a day. While short-term diarrhoea can sometimes help the body get rid of harmful germs or toxins, persistent diarrhoea may cause serious problems such as dehydration, weakness, and poor nutrition, especially when it lasts for weeks.
Diarrhoea can affect anyone occasionally and is often caused by infections from contaminated food or water, whether from bacteria such as E. coli and typhoid, viruses such as rotavirus, or parasites such as amoeba. Other general causes include poor digestion or absorption of food, conditions such as irritable bowel syndrome, and side effects of certain medicines, including antibiotics such as Clavulin.
However, in someone who has had diabetes for a long time, persistent diarrhoea may be linked directly to diabetes itself. This can happen due to diabetic nerve damage (autonomic neuropathy), bacterial overgrowth in the intestines, or poor production of digestive enzymes by the pancreas. In people with type 1 diabetes, conditions such as coeliac disease may also be responsible. In addition, some diabetes medications, especially metformin and gliptins, as well as artificial sweeteners such as sorbitol, are known to cause or worsen diarrhoea.
What is often referred to as diabetic diarrhoea is usually painless. It may occur regularly, alternate with constipation, or disturb sleep by occurring at night. In some cases, it can even lead to difficulty controlling bowel movements. The most important step in treatment is to identify the exact cause. Diarrhoea related to diabetes must be carefully distinguished from infections and other non-diabetic causes that affect both diabetic and non-diabetic patients.
Regardless of the cause, dehydration is a major danger, so it is important to drink plenty of fluids. Probiotics and appropriate dietary adjustments may also help. Depending on the findings, treatment may involve antibiotics for infections, better blood sugar control, adjustment of diabetes medications or the careful use of anti-diarrhoeal medicines under medical supervision.
If diarrhoea has persisted for two months, as in your case, it is essential to seek prompt medical evaluation for proper tests and targeted treatment.