简介：AIM:Todeterminethebowelsymptomsassociatedwithdiabetesanddiabetes-relatedfactorsafterexcludinggastrointestinal(GI)organicdiseases.METHODS:Participantswere4738(603diabeticand4135non-diabetic)patientswhounderwentcolonoscopyandcompletedaquestionnaire.Onthedayofpre-colonoscopy,9symptoms(borborygmus,abdominaldistension,increasedflatus,constipation,diarrhea,loosestools,hardstools,fecalurgency,andincompleteevacuation)wereprospectivelyevaluatedona7-pointLikertscale.Thetest-retestreliabilityofthebowelsymptomscoresfromthebaselineandsecondquestionnaireswasanalyzedusingkappastatistics.Associationsbetweenbowelsymptomscoresanddiabetesordiabetes-relatedfactorswereanalyzedbyarank-orderedlogisticmodeladjustedforrelatedconfounders,andoddsratios(ORs)wereestimated.RESULTS:Inmultivariateanalysis,constipation[adjustedoddsratio(AOR)=1.57,CI:1.33-1.85,P<0.01]andhardstools(AOR=1.56,CI:1.33-1.84,P<0.01)wereassociatedwithdiabetes,andfecalurgency(AOR=1.16,CI:0.99-1.37,P=0.07)andincompleteevacuation(AOR=1.16,CI:1.00-1.36,P=0.06)weremarginallyassociatedwithdiabetes.ThesesymptomsremainedassociatedevenafterexcludingorganicGIdiseasesoncolonoscopy.Test-retestreliabilityofsymptomscorewithameandurationof3.2mowasgood(meankappa,0.69).Associationsofsymptomswithdiabetes-relatedfactorswerefound;constipationwithHbA1c≥8.0%(AOR=2.11,CI:1.19-3.73),bodymassindex(BMI)<25(AOR=2.11,CI:1.22-3.66),andinsulinuse(AOR=1.90,CI:1.08-3.36);hardstoolswithdiabetesduration(AOR=1.03,CI:1.00-1.07);fecalurgencywithBMI<25(AOR=1.73,CI:1.00-2.98);andincompleteevacuationwithBMI<25(AOR=2.60,CI:1.52-4.43),serumcreatininelevel(AOR=1.27,CI:1.10-1.47),andinsulinuse(AOR=1.92,CI:1.09-3.38).CONCLUSION:Diabetesisassociatedwithconstipation,hardstools,fecalurgency,andincompleteevacuation,andpoorglycemiccontrol,duration,leanness,andnephropathyaffecttheriskofthesesymptoms.