One of the joys that long-term diabetics have to look forward to is intestinal trouble. This can be due to one of three things: an infection, a reaction to metformin (one of the drugs that diabetis often take), or autonomic neuropathy. What’s that when it’s at home? Your innards are, of course, run from nerves. Neuropathy is when the nerves die. The autonomic nervous system is what keeps your stomach, small and large intestines, and probably God only knows what else going.
On Sunday morning I awoke at 4 am needing to use the loo. I had a case of diarrhea. Sometimes this happens to everyone, of course, so I washed, and dressed (at 9 am) and went to church. I did tell HWMBO that I would probably not stay but would be back after setting up when my assistant sacristan arrived.
That was the last time I left the house for four days.
I have had the most excruciating diarrhea for the past four days. I have been unable to sleep more than an hour at a time (and that was sometimes a luxury). I had to sleep downstairs in the easy chair because I could not guarantee that I would get out of bed in time to get to the upstairs loo. I have had to race to the loo more times than I can count; I have been cleaning up the mess and generally being very miserable. By this morning I just wanted to die. I had no ambition to do anything except sit in the chair and listen to the radio or watch TV.
I finally called my GP this morning and we discussed my “diagnosis” of autonomic neuropathy. She prescribed something called Lomotil and it seems to (in conjunction with my observation that the symptoms were diminishing) have relieved the diarrhea. I am leaning to the conclusion that the exenatide, which delays emptying of the stomach, might have something to do with this. I shall be getting one more pen but will ask for an urgent appointment at the diabetic clinic when I get back from the US ande ask that they stop the exenatide and start me on insulin. No point in delaying the inevitable now, and since I’ve now gotten used to injecting myself, there’s no difference in injecting lizard spit from injecting insulin.
I ate my first full meal since Sunday this evening. I also slept for 4 hours this afternoon in my bed.
Now to figure out what triggers the condition (it’s not present all the time—there seem to be foods that might set it off) and stop eating it.
I’ve probably lost quite a bit of weight, on the bright side (I suppose there must always be a bright side).
(thanks to
that’s pretty yucky, I’m very glad that you’re on the mend.
I have a tendency for the gut to react in the same way as yours has recently (though the discomfort usually isn’t nearly as bad as you seem to be having of late). My intestinal misbehaviour all got started when I had giardia, and then entamoeba hystolica [aka amoebic dysentery]. It can be pretty miserable. Then after various over-the-counter remedies weren’t doing much, Barrymycutegaydoctor prescribed Lomotil. That stuff is wonderful as an intestinal fire extinguisher, solve-this-problem-NOW. Doesn’t treat the root cause, but it stops the diarrhoea in 30min and keeps it stopped for a day.
I have a supply constantly available, should -er- any fires need to be extinguished.
All the best for your medical checkups and progress later this week.
lomotil is one of the medications i keep handy.
Ugh! Sorry to hear that. Glad it’s easing up, though.
The down side is that Lomotil can stop your diarrhea permanently if you take too much of it.
The lack of motility of your intestine, brought about by either gastric neuropathy or the medication you’re taking, causes increased exposure of the intestine walls to patches of irritant. The obvious cure is to increase motility by the addition of something like cayenne to your diet to keep the gut churning and reduce localized exposure. Common irritants are the foods most recommended to keep us healthy: dairy products with lactose; green vegetables, particularly of the cabbage family; whole grains; and fruits like apples and pears that are high in sorbitol, a strong laxative (also found in gummy bears).
I think that the atropine included with it is supposed to help protect against that. Presumably if one stops going to the toilet, after a while you get a bit full up and other measures will be necessary.
Thanks for this; I shall keep that in mind. I really think it has something to do with the exenatide. The pens are a bit flaky, and I suspect that sometimes you end up with a larger dose than you think. I complained about the second 10mg pen I had (I think it had issues with delivering too much exenatide on occasion). The lizards can keep their spit.
One other question: how long does a bout of this usually last for you? I’m finding that I slid back a bit this evening and I’m now worried about my trip to Boston on Saturday.
Years ago, when I was first diagnosed with diabetic gastric neuropathy, I had a bout that lasted about three weeks. Currently, bouts can take from a couple of hours to about three days, with the longer bouts becoming increasingly rare as I learn to associate my behavior with the results.
I never liked pens for insulin despite trying them several times. I can’t press the plunger without causing lateral movement and the tiny needles cut like a knife. I’m happily using a pump now and only have to jam something sharp into my flesh every two or three days (apart from the finger sticks which happen up to four times daily).
I use a mixture of equal parts cayenne, salt-free garlic powder and turmeric, which my wife also uses instead of pure cayenne. It’s easier to control and adds a better flavor to foods. I also use chili-infused sesame oil in some of my food preparation but you can’t fry with it because if you get it too hot the vapor will burn your eyes and skin. Mustard also helps but isn’t quite strong enough sometimes. A variety of hot sauces work well in moderation, too.
There is much less lactose in goat milk, which I prefer anyway, than in cow’s milk. Hard cheese is almost free of lactose while soft cheeses may be loaded with it. A mixed salad causes fewer problems than a single type of green. If you think you tolerate a particular green, don’t consume it frequently or in large quantities because exposure could cost you your tolerance factor. Simply cooking some vegetables can make them harmless. If you wait long enough, your food tolerance can return, at least temporarily.
why did you wait so long before consulting a doctor?
My experience is that doctors don’t take diarrhea (or diarrhoea, as they spell it here) seriously until you’ve had it for more than 3 days, unless you are an infant or an elderly person. So on the fourth day, I spoke to my doctor.
It seems to have cleared up naturally–I didn’t take any of the medications yesterday at all. The last time I had something like this the doctor thought it was giardia, but a stool sample showed that it wasn’t. She then thought a virus (I had just returned from a trip to India, so either food-borne or a virus was a possibility). Now I realise that it was probably the first bout of autonomic neuropathy. It was in 2005, so 4 years between bouts is OK.
Ahck, hope you get better!