HomeAnswersMedical Gastroenterologybelly bloatingMy diabetic mother has stomach bloating with altered bowel movement and low back pain. Please help.

What could have caused stomach bloating and alternative bowel movement in a diabetic?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ajeet Kumar

Medically reviewed by

Dr. Vinodhini J.

Published At June 5, 2020
Reviewed AtNovember 29, 2023

Patient's Query

Hello doctor,

My mother is 65 years old diabetic. She has hypertension, hypothyroid, and thalassemia minor. She is anemic too. For 10 days, she has been having alternately bloated stomach, diarrhea, constipation, and lower back pain. What could these be symptoms of?

Answered by Dr. Ajeet Kumar

Hello,

Welcome to icliniq.com.

I can understand you must be very upset about your mother for her troubling symptoms.

You know diabetes, hypertension are chronic ailments that can affect every system of the body. Some of these effects, particularly of diabetes, are related to the gastrointestinal tract (GIT). Certain conditions like diabetic gastropathy (involving the stomach), diabetic enteropathy (when involving small bowel) can cause bloating, alternate diarrhea with constipation such as in her case.

It is highly likely that she has one of two of above-mentioned conditions, but to be on the safe side I will suggest you some tests, as we can rule out anything other than this.

Meanwhile, start her on tablet Digestine (Metoclopramide) 40 mg once daily half an hour before meals. Start her on tablet Rifaximin 200 mg thrice daily for three weeks. This is a safe antibiotic which will correct her abnormal bacteria within the small and large bowel. This will help her control her production in the long term. Use Fibrocol or any other fiber which is available two tablespoons full with water once daily with water.

And the most important of all, tight control of her sugars. Since the problem is secondary to diabetes, once diabetes is controlled fairly enough, her symptoms improve itself.

I hope this helps.

The Probable causes

Diabetic gastroparesis. Diabetic enteropathy. Small intestinal bacterial overgrowth. Functional bloating and gas.

Investigations to be done

Complete blood count (CBC). HbA1c (glycated hemoglobin). TSH (thyroid-stimulating hormone), FT4, FT3. Vitamin B12, and RBC folate. Serum albumin, bun , creatinie, electrolytes, calcium, phosphorous, magnesium, serum CRP. Stool for ova and parasites. Stool for fat globules, and reducing substance. Stool for C difficle. Stool for fecal calprotectin. Stool for H pylori antigen.

Regarding follow up

Follow up after 1 week of use of above medication to see how she respond. Meanwhile get above mentioned investigation. Please do not get frightened seeing list of investigations, they are just a through overall assessment of her condition. If she already had some of these tests before, then please do not get those.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar
Dr. Ajeet Kumar

Medical Gastroenterology

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