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For more information visit www.uptodate.com Diabetic Autonomic Neuropathy of the Gastrointestinal Tract (Gastrointestinal Neuropathies) Diabetic autonomic neuropathy, which can have many manifestations, can be divided into groups of conditions as follows: Esophageal dysmotility Gastroparesis Diabetic enteropathies including small bowel dysmotility syndromes, diabetic diarrhea and fecal incontinence [20] Gut complications of diabetes, including diabetic diarrhea and incontinence, small intestinal bacterial overgrowth, non-alcoholic fatty liver disease and exocrine pancreatitis, have a major impact on health outcomes in individuals with long- standing poorly controlled diabetes

This might include referral to a dietitian for personalised nutritional guidance, a weight management service for structured support, or mental health services if body image concerns or disordered eating patterns are present

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For weight loss, they may help patients feel full sooner, reduce hunger, and eat smaller portions as part of a medically supervised program

The result is the prolonged fullness patients describe as feeling "the meal in their chest" hours later, often accompanied by reflux as stomach contents back up against a relaxed lower oesophageal sphincter