[Functional, organic and histologic changes in the stomach in diabetic patients in relation to the presence of diabetic neuropathy].

Functional, organic and histological gastric changes were investigated in relation to the presence of autonomic neuropathy in 105 noninsulin-dependent diabetics (20 with autonomic neuropathy, 35 with peripheral neuropathy, 30 with both peripheral and autonomic neuropathy and 20 without neuropathy) and 40 control persons. The diagnosis of autonomic neuropathy was assessed by parasympathetic test of cardiovascular reflexes and peripheral neuropathy by classical neurological examination and EMG (Electromyogram). All subjects were examined by radiologic and endoscopic methods with gastric biopsy specimens for histologic and immunocytochemical analysis. The results of investigation showed that functional abnormalities, hiatus hernia (55%) and pylorospasm (50%) occur more frequently in patients with autonomic neuropathy. Gastritis, duodenal ulcer (5%) and polyps (25%) are significantly more frequent. Atrophic gastritis type A (20%) was more frequent in diabetics with autonomic neuropathy than in other diabetics, as well as other types of gastritis. Immunocytochemical analysis showed the presence of rare, pale ECL (Extensor Caudae Lateralis) cells in corpus and pale, hypogranulated G cells in antrum and hyperplasia and metaplasia of EC (Embryonal carcinoma) cells in antrum of the stomach. Functional, organic and histologic changes in patients with diabetic autonomic neuropathy suggest that the systemic investigation of the Gut is very important in such patients.