The GI symptoms that are frequently encountered in patients with diabetes mellitus are outlined in Figure 2. Diabetic enteropathy refers to all the GI complications of diabetes and may result in dysphagia, heartburn, nausea and vomiting, abdominal pain, constipation, diarrhea and fecal incontinence (3). Feldman and Schiller reported that 76% of referrals to a diabetic clinic had at least one GI symptom (3). Clouse also reported that GI symptoms were present in a high proportion (20%) of diabetic patients on the registry of a General Clinical Research Center (4). A third study from a tertiary care center reported an increased incidence of GI symptoms in patients with diabetes as compared with control subjects (5). However, in the Rochester Diabetic Neuropathy Study (6), only 1% of patients had symptoms of
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