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Journal of Diabetes Research
Volume 2014, Article ID 784841, 8 pages
http://dx.doi.org/10.1155/2014/784841
Research Article

Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis

1Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
2Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
3Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
4Mech-Sense, Department of Radiology, Aalborg University Hospital, 9000 Aalborg, Denmark
5Institute of Medicine, Department of Internal Medicine & Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden
6Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, 9000 Aalborg, Denmark
7National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, 5020 Bergen, Norway

Received 28 May 2014; Accepted 7 July 2014; Published 22 July 2014

Academic Editor: Dimitrios Papazoglou

Copyright © 2014 Eirik Søfteland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In a clinical setting, diabetic autonomic complications (cardiac, gastrointestinal, urogenital, etc.) are often handled as separate entities. We investigated rectal sensitivity to heat, mechanical distension, and electrical stimulations in 20 patients with diabetes and symptoms of gastroparesis, to evaluate the extent of visceral neuronal damage. Furthermore, to evaluate the relation between the nervous structures we examined gastric emptying and cardiac autonomic function with the hypothesis being an association between these. We found that 60% of patients had delayed gastric empting. Rectal hyposensitivity was a general finding as they tolerated 67% higher thermal, 42% more mechanical, and 33% higher electrical current intensity compared to healthy controls. In patients, most heart rate variability parameters were reduced; they reported significantly more gastrointestinal symptoms and a reduced quality of life in all SF-36 domains. Shortened RR interval correlated with reduced rectal temperature sensitivity, and gastric retention rate was negatively associated with symptoms of nausea and vomiting. To conclude, in these patients with signs and symptoms of diabetic gastroparesis, rectal sensitivity was reduced, and heart rate variability was impaired. Thus, we suggest regarding diabetic autonomic neuropathy as a diffuse disorder. Symptoms of widespread autonomic dysfunction and sensory disorders should be expected and treated in these patients.