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Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 4/2017

01-12-2017 | Motility (H Parkman and R Schey, Section Editors)

Diabetes and the Esophagus

Authors: Roberto Monreal-Robles, MD, José M Remes-Troche, MD, MsC

Published in: Current Treatment Options in Gastroenterology | Issue 4/2017

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Opinion Statement

Chronic hyperglycemia is a well-known cause of gastrointestinal motility disorders extending from the esophagus to the anorectum. Even though little attention has been paid to esophageal disorders in the context of DM, its prevalence is higher compared to gastroparesis. Heartburn, as a typical symptom of gastroesophageal reflux disease (GERD), is the most prevalent symptom and has been found in 25 to 41% of patients with DM. Furthermore, DM has recently been established as possible independent factor for the development of Barrett’s esophagus. The pathophysiology of esophageal disorders in patients with DM is complex and multifactorial, and the mechanisms described include the following: hyperglycemia, autonomic neuropathy, biomechanical and sensory alterations of the esophagus, presbyesophagus, and psychiatric comorbidity. Opportune detection, together with adequate glycemic control, can delay the onset of esophageal dysfunction and slow its progression in diabetic patients. There is limited evidence on patients with DM and esophageal dysfunction, with respect to medical treatment. Lifestyle modifications, prokinetics, and proton pump inhibitors should be indicated on an individual basis in patients that present with DM and esophageal disorders. A greater number of improved studies are needed to develop new therapeutic strategies. This chapter will review esophageal disorders associated with DM and the currently available treatment options.
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Metadata
Title
Diabetes and the Esophagus
Authors
Roberto Monreal-Robles, MD
José M Remes-Troche, MD, MsC
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 4/2017
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-017-0153-z

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