Hyperchlorhydria syndrome refers to a condition characterized by elevated stomach acid production. Antacid drugs, commonly used to manage symptoms of heartburn and acid reflux, may further contribute to digestive disorders in individuals with diabetes mellitus type II (T2DM). The decreased production of stomach acid in hypochlorhydria syndrome can impair the digestion and absorption of nutrients, leading to malnutrition and exacerbating the existing complications associated with T2DM, such as peripheral neuropathy and peripheral artery disease (Yalçın et al., 2019; Akter et al., 2025). Type II diabetes mellitus (T2DM) is a complex and challenging condition that can have far-reaching effects on various bodily systems, including the digestive system. One of the lesser-known yet significant concerns for individuals with T2DM is hyperchlorhydria syndrome, a condition characterized by elevated stomach acid production. This article will delve deeper into understanding hyperchlorhydria syndrome in T2DM patients and explore its implications for digestive health and overall well-being. By shedding light on this often overlooked aspect of diabetes management, we aim to provide valuable insights for individuals and healthcare professionals. Antacid drugs are commonly prescribed to individuals with T2DM to alleviate symptoms of heartburn and acid reflux. However, these antacid drugs may contribute to digestive disorders in T2DM patients. Hypochlorhydria syndrome by antacid drugs more likely creates digestive disorders for T2DM patients due to their ability to reduce stomach acid production. This can further impair the digestion and absorption of nutrients, leading to nutrient deficiencies and worsening the complications associated with T2DM (VSS et al., 2018).

These digestive disorders can include gastroparesis, malabsorption, and bacterial overgrowth in the small intestine. Additionally, impaired stomach acid concentration by antacids can contribute to the development of gastrointestinal symptoms such as bloating, gas, and indigestion. Furthermore, the decreased production of stomach acid in hypochlorhydria syndrome can impair the digestion and absorption of nutrients, leading to malnutrition and exacerbating the existing complications associated with diabetes, such as peripheral neuropathy and peripheral artery disease. Moreover, the use of antacid drugs in T2DM patients with hypochlorhydria syndrome may also hurt glycemic control. Research has shown that low stomach acid levels can affect the breakdown and absorption of carbohydrates, leading to rapid spikes in blood sugar levels after meals. This can make it more challenging for individuals with T2DM to achieve and maintain stable blood sugar control. It is, therefore, important for healthcare professionals to be aware of the potential implications of antacid drug use in T2DM patients and to consider alternative treatment options that do not interfere with normal stomach acid production (Fernandes & Norman, 2019). Patients with T2DM  (conditions associated with too much sugar in the blood) can experience problems with the stomach and intestines. There are several reasons, including nerve damage caused by high or uncontrolled blood sugar (Balaji et al., 2019).

A major nerve in the gastrointestinal tract (called the vagus) signals muscles to push food from the stomach to the small intestine. If diabetes damages this nerve, the food it eats slows down or stops from the stomach to the small intestine. This is called gastroparesis (or delayed gastric emptying) (Abell). Antacids are a group of drugs used to treat conditions caused by hyperchlorhydria produced by the stomach. The stomach naturally secretes an acid called hydrochloric acid that helps to break down proteins. Active acid secretion produces stomach conditions that become acidic with pH measuring at 2 or 3. (pH levels determine stomach acidity strength through numerical values where lower numbers indicate higher acidity rates). Several protective mechanisms protect the stomach, duodenum, and esophagus from acid. A strong acid concentration combined with insufficient protective mechanisms enables acid to damage stomach lining and duodenum and esophageal tissue causing inflammation and ulcer formation resulting in gastrointestinal symptoms such as nausea and abdominal pain and heartburn from GERD (Ravisankar et al., 2016; Fatema et al., 2025). The study aimed to find out whether hypochlorhydria caused by antacid drugs is more likely to cause digestive disorders in diabetes mellitus type II patients and to determine the relationship between demographic characteristics and digestive disorders in patients with hypochlorhydria caused by antacid drugs for gastric hyperacidity.

A purposive (non-probability) sampling technique was used to gather (250) T2DM patients with digestive problems who required antacid drugs to prevent gastric hyperacidity from (40 to 79 years of age) and were selected from Baghdad Teaching Hospital/ Medical City and Gastroenterology and Hepatology Teaching Hospital in Baghdad City (consultant clinics). The investigation analyzed antacid drug-induced hypochlorhydric effects on gastric hyperacidity and digestive disorder among T2DM patients in the consultant clinic period from December 10th, 2021 to August 25th, 2022 at Baghdad Teaching Hospital/Medical City and Gastroenterology and Hepatology Teaching Hospital in Baghdad city (Consultant Clinic) in Baghdad city. A questionnaire was made by the researcher to examine how antacid drugs cause hypochlorhydria in gastric acid patients who present with digestive disorders. Statistics involved frequency and percentage in description analysis while the correlation coefficient helped conduct inferential analysis. This research used scores Perpson Likert scale measures to evaluate data through the combination of t-test analysis and stepwise multiple regression.

A questionnaire was constructed for the purpose of the study. It was composed of (2) major parts, and overall items included in the questionnaire were (29) items. Part I consists of (5) items related to demographic data for hypochlorhydria by antacid drugs for gastric hyperacidity for T2DM patients, which consisted of age, gender, residential area, socio-economic status, and body mass index. Part II consists of (6) items, including the symptoms of digestive disorder, dietary pattern, antacid drugs, bad eating habits, history, and antacid drugs for T2DM patients with gastric hyperacidity. Reliability was determined through a pilot study. The data was analyzed by applying the descriptive statistics (Frequency and Percentage) and the inferential statistical data analysis approach Mean of the score, Standard Deviation, Chi-square, and Person correlation coefficient for all the patients under treatment and diagnosis by physician.

Table 1: Mean of scores for items symptoms of hypochlorhydria by antacid drugs for T2DM patients creates to digestive disorder and the association between symptoms for hypochlorhydria by antacid drugs creates to digestive disorder for T2DM patients.

The distribution of the matched demographic characteristics out of this table indicates that most patients were (60-69) years old and were (38%) of the study. Most of them were males (69.2%), living in urban (77.2%) for items related to residential areas. Regarding the socio-economic status, the scale (44%) had a high score, and the body mass index (41.6%) was overweight for hypochlorhydria by antacid drugs creates digestive disorders in T2DM patients. 

The Supplementary Table 1 shows that there was a highly significant association between age, gender, residential area,  socio-economic status scale, and body mass index for hypochlorhydria by antacid drugs creates digestive disorder for T2DM patients.

Table 2: Mean scores for items of the dietary pattern for hypochlorhydria caused by antacid drugs in T2DM patients and the association between dietary pattern and hypochlorhydria caused by antacid drugs in T2DM patients.

The supplementary Table 2 indicated that the mean of scores is highly significant on items (2, 3, 5, 6, 7, 10, 11, 13, 15, 18, 23), significant on items (1, 4, 8, 12, 14, 16, 17, 19, 20, 21, 22, 24, 25), no significant on items (9) for items symptoms for hypochlorhydria by antacid drugs for T2DM patients creates to digestive disorder. The table also shows that the association between symptoms and digestive disorders was significant for hypochlorhydria by antacid drugs for T2DM patients treating digestive disorders. This table shows that the mean of scores is highly significant on item (1, 2, 4, 6, 7, 8, 9, 11), significant on items (3, 5, 15) and the remaining was no significant on items (10, 12, 13, 14).

The table also shows that the association between dietary pattern and digestive disorder was significant hypochlorhydria by antacid drugs creates to digestive disorder for T2DM patients.

Table 3: Mean scores for items of bad habits during eating foods and digestive disorders for hypochlorhydria caused by antacid drugs create digestive disorders for T2DM patients.

This table shows that the mean of scores is highly significant on item (2, 3, 5, 6), and significant on items (1, 4). The table also shows that the association between bad habits and digestive disorder was significant for hypochlorhydria by antacid drugs created in digestive disorder T2DM patients.

Table 4: Mean, Std. Deviation, Variance, and Chi-Square for past history to hypochlorhydria by antacid drugs create digestive disorders for T2DM patients.

This table shows the mean of scores, Standard deviation, Variance, and Chi-Square. The table also shows that the association between past history and hypochlorhydria by antacid drugs creates to digestive disorders for T2DM patients was strong and highly significant.

Table 5: Mean of scores for items of the use antacid drugs for hypochlorhydria by antacid drugs creates to digestive disorder for T2DM patients.

This table shows that the mean of scores is highly significant on item (2, 4) and significant on items (1, 3) for items related for use of antacid drugs with gastric hyperacidity T2DM patients and digestive disorder. The table also shows that the association between antacid drugs and digestive disorders for T2DM patients was significant.

Table 6: Pearson correlation between age, gender, residual area, socio-economic status, body mass index, symptoms, dietary patterns, bad habits, history and antacid drugs for digestive disorder T2DM patients was significant.

C = Cell, Co. = Correlation coefficient,   Sig. = Significant (2- tailed), N. = Number of sample. SES = (Socio-economic status Scale),   B. M. I. = Body Mass Index. This table shows that the relationship in the all of the cells.

 (C1 It means relationship between age and gender, C13 It means relationship between age of Body Mass Index and …etc.). 

**. Correlation is significant at the 0.01 level (2-tailed).

Table 2 indicated that there was a strong positive relationship in cell (25, 29, 50, 3, 7, 9, 11, 12, 13, 17, 18, 19, 20, 21, 23, 27, 30, 33, 34, 35, 36, 44, 47, 48, 49, 1, 2, 4, 5, 6, 10, 16, 22, 24, 26, 28, 31, 41, 8, 14, 15, 32, 37 and 45), positive relationship in cell (46, 40, 43, 42, 39 and 38). 

Supplementary Table 1 show the distribution of the study sample (250) by their demographic characteristics such as (age, gender, residential area, socio-economic status and Body Mass Index) and association between demographic data for hypochlorhydria by antacid drugs for gastric hyperacidity for T2DM patients and digestive disorder. The mean age was (62.5). The distribution of the matched demographic characteristics out of this table indicates that most patients were (60-69) years old and were (38%) of the study. Most of them were males (69.2%), living in urban (77.2%) for items related to residential areas. The socioeconomic status scale (44%) had a high score, and the body mass index (41.6%) was overweight. The table also shows a highly significant association between age, gender, residential area, socio-economic status scale, and body mass index.

The number of upper gastrointestinal diseases keeps rising among individuals who have reached 65 years of age or above. The high prevalence of gastroesophageal reflux disease (GERD) in older adults can be attributed to natural aging effects that alter the normal processes of the esophagus. Elderly patients show dissimilar GERD symptoms than those experienced by adult and young individuals (Adanir et al., 2021). 

The prevalence of GERD conditions grows due to rising older age in many worldwide populations whose life expectancy increases faster. GERD occurrence increases with age and researchers have observed that males experience this condition more frequently than women do. A research study conducted in Pakistan examined GERD patients from the region to determine how older individuals during diagnosis experienced worse overall life quality. The older generation has poor esophageal acid clearance together with weakened defense mechanisms in their esophageal mucosa (Zheng et al., 2021). Aging causes muscles to weaken. This includes weakening in the lower esophageal sphincter (LES). When the person eats, food goes down through the throat and esophagus into the stomach. The LES is the circular muscle that controls the opening between the esophagus and the stomach. The LES is closed when the person is not eating, preventing stomach juices from flowing back into the esophagus. As the age, the LES can weaken and stop functioning properly (Bredenoord et al., 2016). T2DM and overweight/ obesity are major public health burdens that pose management challenges in clinical practice. Patients with T2DM, 85% of whom are overweight or obese, often have an increased incidence of cardiovascular disease (CVD) risk factors, including hypertension and dyslipidemia. The latest National Health and Nutrition Examination Survey (NHANES) shows that only 1 in 8 patients with diagnosed diabetes can simultaneously achieve target goals for glucose, blood pressure, and lipids. Renewed efforts are needed for satisfactory glycemic control and improved cardiovascular (CV) outcomes. The objective of this supplement to The American Journal of Medicine is to review the pathophysiology of type 2 diabetes with a focus on the role of incretin hormones in the mechanisms of disease onset (Brunton, 2016).

Excess weight can be due to several reasons, including hormone imbalances, poor eating habits, unhealthy lifestyles, or other underlying health conditions. Many people who are overweight consume large meals. Large meals can exert pressure on the lower esophageal sphincter, causing it to partially open and allow stomach acids to fill into the esophagus. Losing excess weight with a safe, sensible diet and moderate exercise can help improve acid reflux in those who are overweight (Surdea-Blaga et al., 2019). Supplementary Table 2 shows that the mean of scores for items symptoms of gastric hyperacidity patients and the association between gastric hyperacidity for T2DM patients and digestive disorder. The table indicated that the mean of scores is highly significant on items (2, 3, 5, 6, 7, 10, 11, 13, 15, 18, 23), significant on items (1, 4, 8, 12, 14, 16, 17, 19, 20, 21, 22, 24, 25), no significant on items (9) for items symptoms of gastric hyperacidity for T2DM patients.

The table also shows a significant association between gastric hyperacidity T2DM patients and digestive disorders. The combination of high diabetes risk raises your susceptibility to heart disease alongside obesity but research reveals the condition also harms your gastrointestinal system including your gut. When blood sugar remains uncontrolled it attacks nerves as the treatment targets both stomach and intestinal tissues. Diabetes affects the gastrointestinal system of people who have this condition (Balaji et al., 2019). The presence of T2DM affects all major systems inside the body based on how long the disease has been present and its intensity together with any secondary medical conditions. Patient suffering from diabetes often develops gastrointestinal manifestations that lead to esophageal dysmotility while also causing gastroesophageal reflux disease (GERD) along with gastroparesis and enteropathy and non-alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. The intensity of GERD slows down directly in proportion to diabetic control through medicinal prokinetic and proton pump inhibitor interventions. The symptoms of diabetic gastroparesis include early satiety, bloating, vomiting, abdominal pain and unpredictable blood sugar levels (Krishnan et al., 2013).

A prolonged period of T2DM treatment frequently results in gastrointestinal problems affecting the small intestine alongside the colon and rectal areas. The process of body digestion is delayed by nerve damage that results from diabetic complications in the intestines. Constipation develops due to this process which allows unhealthy bacteria to thrive. The patients will likely experience diarrhea although diarrhea combined with constipation represents the primary enteropathy symptom (Awuchi et al., 2020).

Heartburn, also called acid indigestion or acid reflux, is the most common symptom of GERD. The patients feeling of discomfort that develops just starts behind and below the breastbone and can rise to the neck and throat. Heartburn is a burning chest pain. It can last as long as 2 hours. It often feels worse after eating. Lying down or bending over can also cause heartburn. Another common symptom of GERD is bringing swallowed food up again to the mouth (regurgitation). Some people can have trouble swallowing (Birchall & Wood, 2024). The stomach acids produce a sour taste in the mouth. The sour taste experienced from stomach acids together with GERD and reflux-induced burping and coughing may lead to nausea and vomiting in various situations (Hunt et al., 2014). Table 1 shows that the mean of scores for items of the dietary pattern for gastric hyperacidity patients and the association between gastric hyperacidity T2DM patients and digestive disorder. This table shows that the mean of scores is highly significant on item (1, 2, 4, 6, 7, 8, 9, 11), significant on items (3, 5, 15) and the remaining was no significant on items (10, 12, 13, 14). The table also shows a significant association between dietary patterns and digestive disorders for T2DM patients.

Dietary patterns play an important role in the development of the disease, but the current epidemic indicates lifestyle changes. Irregular dietary patterns, overweight, and obesity are considered important risk factors for Type 2 diabetes, which result from imbalanced food intake and caloric expenditure, often due to an unhealthy lifestyle, insufficient physical exercise, and unhealthy food consumption. These facts show that environmental elements are the main causes of the increase in type 2 diabetes. Diet is one of the main risk factors that modifies other risk factors. With the onset of diabetes, food choices and eating habits are crucial in controlling disease progression (Wu et al., 2014). The main nutritional approach is to investigate the nutrients or food and their relationship with chronic diseases, including diabetes. However, the human diet is complex since foods are not consumed in isolation, and the nutrients operate synergistically or inhibit, making it difficult to detect these possible associations. This fact justifies the global consideration of using dietary patterns as an alternative to overcome these limitations, analyzing the effects of multiple dietary factors on the individuals health. Thus, it is important to know the eating patterns of diabetic individuals and their association with clinical aspects of the disease (Vitale et al., 2018). Table 2 shows the mean scores for items of bad habits while eating foods for gastric hyperacidity T2DM patients and those with digestive disorders. This table shows that the mean of scores is highly significant on item (2, 3, 5, 6), and significant on items (1, 4). The table also shows a significant association between dietary patterns and digestive disorders for T2DM patients.

Some bad habits include Skipping breakfast, sitting for longer than 30 minutes at a stretch, Drinking water during meals, sleeping immediately after meals, Eating processed foods, Swallowing food, and smoking. These bad habits must be Struggling to kick, which leads to digestive disorders for T2DM patients (Thomas, 2017). Diabetes mellitus is a significant global health issue affecting people worldwide, causing deaths each year. The most common type is type 2 DM, which is associated with lifestyle and bad habits, changes that lead to insulin resistance. It is a metabolic disease characterized by high blood sugar levels due to problems with insulin secretion, insulin action, or both, and disrupted metabolism of carbohydrates, fats, and proteins. This can lead to several health problems, including gastrointestinal disorders, heart disease, stroke, blindness, kidney failure, and immune suppression (Renu et al., 2020). Acid reflux or gastroesophageal reflux (GER) results from a backward flow of stomach acid into the esophagus. This is the tube that connects the stomach to the throat. Various reasons, including poor eating habits, food intolerances, bad habits for dietary patterns, obesity, stress, or dietary and lifestyle choices, can cause it. In this condition, the person must be modification dietary pattern. If the condition is caused by dietary and lifestyle choices, changing the habits can relieve symptoms (Yasutake et al., 2014).  Changing the eating habits which its best to eat several small meals instead of two or three large meals and wait 2 to 3 hours after eat, not to be lie down at late-night snacks arent a good idea. Avoid spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people (Surdea-Blaga et al., 2019). Table 3 Mean, Standard deviation, Variance, and Chi-Square for past history of digestive disorder in T2DM patients. This table shows the mean of scores, Standard deviation, Variance, and Chi-Square 

The table also shows that the association between past history and digestive disorders for T2DM patients was highly significant. The chronological examination of gastrointestinal abnormalities includes evaluations of the esophagus stomach pancreas gall bladder biliary tract together with jaundice caused by diabetes mellitus type 2. Gastroesophageal reflux disease stands as the main esophageal disease which occurs when gastric contents leak through the incompetent lower esophageal sphincter to produce symptoms. The lower region of the esophagus narrows down into a fibrotic constriction because of injury in most instances due to reflux esophagitis. The motor disorders affecting the esophagus show dysfunctional motor mechanics which include three main diseases – achalasia, diffuse spasm, and presbyesophagus. The esophageal manifestations arising from other diseases like diabetes form different patterns from those of reflux-despite-incompetent-lower-esophageal-sphincter symptoms (DeVault & Achem, 2021). A high number of digestive disorders affected type 2 diabetes mellitus patients. A review study identified old age with hypertension and cardiac disease as well as smoking and obesity and time spent with diabetes mellitus as dependent variables for digestive disorder diseases in type 2 diabetics. Type 2 diabetic patients must have both preventive and curative intervention strategies developed for gastrointestinal disease management because adequate awareness programs and early-stage medication must be combined with supportive healthcare environments (Helwig et al., 2024). Table 4 Mean scores for items of the antacid drugs for gastric hyperacidity T2DM patients and digestive disorder. This table shows that the mean of scores is highly significant on items (2, 4) and significant on items (1, 3). The table also shows that the association between antacid drugs and digestive disorders for T2DM patients was significant. The use of antacid drugs in patients with T2DM is associated with an increased risk of digestive disorders, specifically hypochlorhydria syndrome. This condition is characterized by low stomach acid production, which can lead to impaired digestion and absorption of nutrients. Impact of hypochlorhydria on digestive function hypochlorhydria, or low stomach acid production, can have a significant impact on digestive function in patients with type II diabetes. It can lead to insufficient breakdown of food, which can result in malabsorption of nutrients and digestive disorders such as bloating, gas, indigestion, and nutrient deficiencies. Importance of proper digestion in T2DM management proper digestion plays a crucial role in the management of T2DM (Lin et al., 2016).

Deficiency of hydrochloric acid in the stomach by using antacid drugs impairs stomach secretions, which are made up of hydrochloric acid, several enzymes, and a mucus coating that causes defects in protecting the lining of the stomach. Hypochlorhydria is a deficiency of hydrochloric acid in the stomach. Stomach secretions comprise hydrochloric acid, several enzymes, and a mucus coating that protects the stomachs lining. Hydrochloric acid helps the body to break down, digest, and absorb nutrients such as protein. It also eliminates bacteria and viruses in the stomach, protecting the body from infection (Hodgson, 2020). T2DM is a chronic metabolic disorder characterized by high blood glucose levels due to insulin resistance or impaired insulin production. Antacid drugs are commonly used to manage gastric hyperacidity in these patients. However, the use of antacid drugs can potentially lead to hypochlorhydria syndrome, a condition characterized by low stomach acid production. This syndrome can harm the digestive system, leading to various digestive disorders in diabetes mellitus type II patients (Ma et al., 2019). Hypochlorhydria syndrome and digestive disorders. These drugs, which aim to reduce stomach acid production, can lead to a decrease in gastric acidity levels. This decrease in gastric acidity, known as hypochlorhydria, can disrupt the normal sequence of digestion and absorption in the gastrointestinal tract, leading to various digestive disorders (Greenwood-Van Meerveld et al., 2017).

Low levels of hydrochloric acid can profoundly impact the bodys ability to digest and absorb nutrients properly. If the patient continue to use antacid drugs to do hypochlorhydria can cause damage to the gastrointestinal (GI) system, infections, and several chronic health issues (Koyyada, 2021). Increased heartburn happens  associated with frequent cases of reflux or heartburn. Also, medications are a big factor. As we age and are diagnosed with more minor and moderate health problems, our needs for medication increase. Many medication classes as a whole, such as antidepressants and blood pressure medications, are linked to increased heartburn (Savarino et al., 2023). Table 5 Pearson correlation between age, gender, residual area, socio-economic status, body mass index, symptoms, dietary patterns, bad habits, past history and antacid drugs.

The table indicated that there was strong positive relationship in cell (25, 29, 50, 3, 7, 9, 11, 12, 13, 17, 18, 19, 20, 21, 23, 27, 30, 33, 34, 35, 36, 44, 47, 48, 49, 1, 2, 4, 5, 6, 10, 16, 22, 24, 26, 28, 31, 41, 8, 14, 15, 32, 37 and 45), positive relationship in cell (46, 40, 43, 42, 39 and 38).  Hypochlorhydria shows similar indications as Hyperchlorhydria yet medical providers together with patients treat non-diagnosed low acid levels through antacid medication. Using antacids produces harmful consequences because they fail to detect the underlying issue which continues to trigger malnutrition symptoms and gastrointestinal discomfort from reduced stomach acid levels. Moreover the medication further inhibits stomach acid development leading to worse Hypochlorhydria condition in the long term (Ravisankar et al., 2016). People with Hypochlorhydria who take antacid drugs often need years to receive proper digestive diagnosis while their nutrition declines and stomach and gut parasitic infection risks rise. Antacids have become too available since many people misunderstand how stomach acid levels manifest leading to extensive incorrect use of both over-the-counter and prescription antacid medication by American adults and other worldwide populations (Levy, 2023). Multiple studies prove that fatty foods combined with chocolate ingestion leads directly to reflux symptoms while certain specific foods and beverages act as known triggers for reflux. Excessive consumption of combinations of alcohol and caffeine-based drinks has been scientifically linked to reflux development. The combination of alcohol and cigarette smoking intensifies reflux symptoms because it weakens the lower esophageal sphincter pressure. Research reports that enduring stress possibly plays a part in the development of GERD. Research teams used adverse psychosocial influences in adult life as their definition for stress while noting that subjects under heavier life stress presented more GERD symptoms. Stress leads to greater perception of acid exposure inside the esophagus. Health-related actions such as smoking together with alcohol use and diet choices alongside physical exercise patterns can affect reflux risk based on how these behaviors are influenced by stress. Research findings demonstrate that physical activity at higher levels exists as a direct link to reflux rates which leads to heartburn alongside regurgitation and belching symptoms (Sawada et al., 2020).

Global health experts identify GERD as a widespread condition because our understanding of this disease has significantly improved since the 1950s. Environmental conditions with genetic predisposition together with dietary changes and physical inactivity have caused the rise of prevalence rates. The global increase in diabetes mellitus type 2 expectancy may possibly result because of higher GERD prevalence. Advanced knowledge of GERDs pathology and symptoms exists currently but future studies are required to produce non-invasive diagnostic methods and innovative therapeutic approaches (Zhang et al., 2015). Gastrointestinal disorder incidence levels differ from nation to nation but reach their peak in the United States. The review identified old age as well as hypertension together with cardiac disease and smoking alongside obesity and Hyperchlorhydria and history of type 2 diabetes mellitus as predictor variables which lead to digestive disorders among diabetic patients. Patients who have type 2 diabetes mellitus experience higher probability for serious complications affecting their kidneys and cardiovascular system. Decreasing the mortality rates and disease burden among type 2 diabetic patients needs preventive along with curative intervention strategies that should include early-stage medicine prescriptions and environmental support systems and disease awareness programs.

The study results showed the sample population consisted mostly of urban males with a mean age of (62.5) years and high socio-economic status and overweight body mass index. Results show a substantial relation between symptoms and dietary patterns as well as bad habits and past histories and antacid drug use and digestive disorders in patients who have diabetes mellitus type 2.

• Guide notebook, to identify the dietary pattern and how to control and prevent bad habit to prevent digestive disorder which are leads to complication. 
• Avoid antacid drugs to improve normal sequence of digestion and absorption is dependent upon the anatomic and physiologic integrity of the upper gastrointestinal tract. 
• The key to improving our digestion is governorate our stomach acid by reducing antacid drugs by alternative substances nutrient.
• Adequate HCl production is dumping of acidic chyme into the small intestine is necessary to stimulate the release of hormones, pancreatic enzymes, and bile. In order to have optimal absorption of several nutrients, including folic acid, ascorbic acid, beta-carotene, non-heme iron, and some forms of calcium, magnesium and zinc.
• Eating healthy fermented foods and beverages, and cutting out processed foods. When we couple that with Body Ecologys digestive enzymes, well be able to kick indigestion to the curb and finally have the health and energy we have been hoping for.

We adhered to ethical guidelines for conducting research involving human subjects in this study.

The data used in this study are available from the corresponding author upon request.

No Conflicts of Interest declared.

To the supporters of the researchers who helped and supported them, the author expresses their gratitude.