Autonomic neuropathy refers to damage to the nerves within the autonomic nervous system. The heart, blood, sweat production, and digestion are particularly affected. A side effect of other diseases, autonomic neuropathy must be cured by therapy for the disease causing it.
What is autonomic neuropathy?
Autonomic neuropathy is a nerve disorder that has undesirable effects on uncontrolled body functions, such as heart rate, blood pressure, perspiration, and digestion. It is not a specified disease. Autonomic neuropathy refers to damage in the autonomic nervous system. This damage disrupts the connections between the brain and parts of the autonomic nervous system. These include the heart, blood vessels, and sweat glands. Consequently, there may be abnormal manifestations in the uncontrolled body functions. Autonomic neuropathy can be a side effect of several disorders and conditions. Thus, there are also medications in which autonomic neuropathy may occur as a side effect. The signs and symptoms of autonomic neuropathy depend on the cause of the disorder and which nerves are affected in a particular case.
Causes
Autonomic neuropathy can be a result of many disorders and diseases and a side effect of certain medications. Some common causes of autonomic neuropathy are:
Abnormal accumulation of proteins in organs (amyloidosis), which cause changes in organs and nervous system; Autoimmune diseases, which cause the body’s own immune system to attack its own body cells (ex. Diabetes is the most common cause of autonomic neuropathy and can damage the body’s nerves with increasing intensity; trauma, as a result of which certain nerves have been severely damaged; medications, especially cancer drugs (chemotherapy), antidepressants, and heart medications; other chronic diseases, such as Parkinson’s disease; some viruses and bacteria. Parkinson’s disease; some viruses and bacteria, including botulism, leprosy, diphtheria; congenital disorders can also lead to autonomic neuropathy.
Symptoms, complaints, and signs
Depending on the underlying disorder or disease causing autonomic neuropathy, nerve damage may manifest itself with different symptoms and complaints. If an autoimmune disease is causative, symptoms may include circulatory problems, rapid heartbeat, and dizziness. The increased susceptibility to infection can trigger infections and secondary diseases. In addition, edema can occur in different parts of the body. Furthermore, autonomic neuropathy can manifest itself through gastrointestinal complaints such as nausea and vomiting, diarrhea and flatulence. In the skin, dry skin, dandruff and increased sweating may occur. The respiratory tract is often affected as well, which can be irritated, resulting in swallowing difficulties and inflammation, among other symptoms. Furthermore, nerve damage can lead to temporary or permanent incontinence. Depending on the cause, other functional disorders may occur: Paralysis symptoms, neurological complaints, organ dysfunction, movement restrictions and incorrect posture. If the nerve damage is due to cancer, external changes occur, such as weight loss, pale skin and, under certain circumstances, hair loss. Due to the large number of possible symptoms, autonomic neuropathy can only be diagnosed on the basis of a comprehensive medical diagnosis. The symptoms mentioned may change and increase in intensity as the disease progresses.
Diagnosis and progression
Many diseases and disorders can lead to autonomic neuropathy. For a possible therapy, it is important to find out the cause of the nerve damage at the beginning. Patients with diabetes or cancer are in the risk group for autonomic neuropathy anyway. However, if the patient does not belong to the risk group, diagnosis is more complicated and may involve a number of other tests in addition to an analysis of personal medical history and a physical examination. For example, a breathing test may provide clues, measuring heart rate and blood pressure while the patient performs certain breathing exercises. Another test involves checking blood pressure and pulse while performing certain physical activities (lying down, squatting, standing up, etc.). A gastrointestinal test checks the movement of food in the system.Other tests can check the function of the sweat glands or reveal malfunctions in the bladder, for example, by ultrasound.
Complications
Usually, autonomic neuropathy causes severe damage to the nervous system. As a result, the function of various organs or regions of the body may be affected. These include, most notably, the sweat glands, digestion, and the heart. Those affected also suffer from diabetes during the disease. Serious diseases of the cardiovascular system occur, so that the patient suffers from heart problems. These can manifest themselves in different forms, so that, for example, heart palpitations occur. Likewise, the affected person is often no longer able to perform any physical activities and is thus severely restricted in his daily life. Likewise, flatulence and diarrhea occur. In addition, most patients also suffer from nausea and vomiting. If the disease arises from cancer, treatment is not possible in every case, so that in the worst case death occurs. The treatment itself always depends on the underlying disease. If it is started at an early stage, the nerve damage can be reduced if necessary, so that there are no further complications. However, some patients also suffer from incontinence, which can be a burden on everyday life. Damage to the heart is treated with the help of medication. Similarly, the sweat glands can also be reactivated with the help of glycopyrronium bromide.
When should you go to the doctor?
In case of circulatory problems, palpitations, gastrointestinal complaints and other typical signs of autonomic neuropathy, a doctor must be consulted. Medical clarification is particularly urgent if several symptoms occur at the same time and these increase during the course of the disease. For example, nausea and vomiting in conjunction with dry skin and increased sweating suggest a serious illness. A physician must clarify whether this is an autonomic neuropathy or another disease. Risk groups include patients with diabetes, cancer or cardiovascular disease. So are smokers, overweight people and people with alcoholism. Anyone suffering from any of these diseases or conditions should talk to a doctor immediately if they experience any unusual symptoms. If autonomic neuropathy is left untreated, it can become severe. At the latest, if chronic pain or fatigue occurs, a doctor must clarify the cause. Severe symptoms such as chronic diarrhea, circulatory collapse or heart attacks are a medical emergency. The affected person himself or an observer must call an ambulance and, if necessary, perform first aid measures.
Treatment and therapy
Treatment usually involves treating the causative disease rather than the autonomic neuropathy directly. As a sequelae of many diseases, the nerve disorder will regress in most cases if the disease is treated successfully. If the digestive tract is affected by the nerve disorder, the doctor will recommend dietary changes to relieve symptoms. Certain medications may help speed the progress of food. For bladder problems, a doctor may recommend following strict schedules of fluid intake and urination. Medications such as bethanechol may help empty the bladder completely so that unwanted incontinence does not occur. Overactive bladder is also possible and can be treated with medication. Men may complain of erectile dysfunction with autonomic neuropathy, this can be treated with sildenafil. Lubricants may help with an overly dry vagina in women. Effects on the heart and blood pressure should also be controlled with the use of medications (e.g., midodrine and pyridostigmine). The drug glycopyrronium bromide can cut back sweat gland production in cases of excessive perspiration.
Outlook and prognosis
The prognosis of autonomic neuropathy depends on the underlying disease present. It is often a chronic disease for which a cure is not possible. The therapeutic approaches of a disease with a chronic course provide for the alleviation of the various accompanying symptoms in order to enable a good quality of life with the disease. In particular, freedom from pain and functional ability of the organs are in the foreground.Therefore, since autonomic neuropathy is not treated directly, no cure can be expected. Furthermore, the damage to the nerves is irreparable in many cases. The replacement or regeneration of nerve fibers is so far not possible with the given scientific and medical methods. Nevertheless, there is recovery in patients diagnosed with autonomic neuropathy, if via medical treatment the underlying disease was cured. This is especially possible in the case of diseases of the bladder or digestive tract. After the hyperfunction of the bladder has been cured, the neuropathy regresses independently. The prognosis prospects improve with adherence to a healthy lifestyle. With a balanced diet, avoidance of harmful substances and a stable immune system, the patient’s health improves considerably. Normal weight should be maintained and consideration should be given to the needs of the organism.
Prevention
Certain diseases favor the development of autonomic neuropathy. Here, patients must pay special attention to their health condition and listen to their doctor’s instructions. In the case of diabetes, blood glucose levels should be kept under control. Alcoholism must be fought, as well as the smoking habit, and regular exercise should be done, as well as maintaining a healthy body weight.
Follow-up
The causes of autonomic neuropathy cannot be treated. Only the typical symptoms can be alleviated by doctors. Thus, lifelong follow-up care becomes necessary. Because a variety of conditions can trigger autonomic neuropathy, initial diagnosis takes a comparatively long time. Depending on the severity of the signs, certain procedures are repeated in the context of follow-up care. This is to document the progress of the disease. Complications can also be ruled out in this way. Possible diagnostic procedures include imaging examinations such as X-rays and sonography, ECG, blood determinations and blood pressure measurements. In addition to medical monitoring, patients themselves are responsible for their own state of health. Both aspects are equally important for the success of treatment. In principle, all health-promoting measures should be taken, including a balanced diet, abstinence from addictive substances such as nicotine and alcohol, and regular physical exercise. If diabetes is present, it is essential to keep blood glucose levels low. Patients must lose any excess weight. Stress should also be avoided. Medications are often administered as part of the therapy. These must be taken continuously. Discontinuation immediately leads to a resurgence of symptoms. Affected persons should pay attention to body signals and contact their physician in the event of acute changes.
What you can do yourself
If type 2 diabetes mellitus is the trigger for autonomic neuropathy, the patient can best help himself by changing his lifestyle and dietary habits. If the patient is considerably overweight, a weight loss of at least ten kilos is advisable first. If reduction diets have not shown lasting success in the past, those affected should definitely seek professional help and consult a nutritionist. Very often it is not enough to simply reduce food intake; instead, a complete change in diet is required. In most cases, however, this plan fails because the patient lacks the necessary motivation or stamina. The exchange with other affected persons in a self-help group is often very beneficial here. If autoimmune diseases are the cause of the autonomic neuropathy, patients should find out whether there is a connection between acute episodes of the autoimmune disease and certain external factors, for example certain foods or stress situations, and avoid these factors as far as possible. Individual symptoms of autonomic neuropathy can also be alleviated with mild home remedies. For flatulence, a teaspoon of cumin chewed slowly helps. Dried blueberries, which are also very tasty, provide quick help for non-specific diarrhea. If you do not want to collect them yourself, you can buy them in herbal stores or order them on the Internet.
