What is autonomic neuropathy?

Neuropathy No More By JODI KNAPP Neuropathy No More is an eBook which is a compilation of all the essential information and details about the nervous system and how to keep it active and healthy. With the help of this program, one can get a relief from the symptoms of neuropathy. This eBook not only tells you about the nervous system, but also helps to provide essential information to get relief from the condition of neuropathy. It also provides information about how you can prevent this condition from coming back in the near future.

What is autonomic neuropathy?

Autonomic neuropathy is a type of nerve damage that affects the autonomic nervous system (ANS), which controls involuntary bodily functions such as heart rate, blood pressure, digestion, bladder control, and temperature regulation. When the autonomic nerves are damaged, these automatic body functions may become disrupted, leading to a wide range of symptoms. Autonomic neuropathy can result from various conditions, most commonly diabetes, and can have a significant impact on quality of life.

Causes of Autonomic Neuropathy:

Autonomic neuropathy can be caused by several underlying health conditions, including:

Diabetes:
- Diabetic autonomic neuropathy is one of the most common causes. Prolonged high blood sugar levels damage the autonomic nerves, especially in people with poorly controlled diabetes.
Autoimmune Diseases:
- Conditions like lupus, rheumatoid arthritis, and Sjögren’s syndrome can cause inflammation that attacks the nerves, leading to autonomic dysfunction.
Infections:
- Certain viral or bacterial infections, such as HIV, Lyme disease, or leprosy, can damage the autonomic nerves.
Chemotherapy and Radiation Therapy:
- Some cancer treatments, especially chemotherapy, can cause nerve damage, leading to autonomic neuropathy.
Alcoholism:
- Chronic alcohol abuse can cause nerve damage, leading to alcoholic neuropathy, which may involve autonomic nerves.
Inherited Neuropathies:
- Genetic conditions like familial amyloid polyneuropathy (FAP) or Charcot-Marie-Tooth disease can affect the autonomic nervous system.
Other Medical Conditions:
- Kidney disease, liver disease, vitamin deficiencies (particularly B12), and certain neurological disorders (e.g., Parkinson’s disease) can also lead to autonomic neuropathy.

Symptoms of Autonomic Neuropathy:

The symptoms of autonomic neuropathy depend on which part of the autonomic nervous system is affected. Since the autonomic system controls many body functions, symptoms can vary widely, affecting the heart, digestive system, bladder, sexual function, and more.

Cardiovascular System:
- Orthostatic Hypotension: A sudden drop in blood pressure when standing up, causing dizziness, lightheadedness, or fainting.
- Abnormal Heart Rate: Heart rate may become abnormally fast (tachycardia) or slow (bradycardia), or may not adjust properly during physical activity.
Gastrointestinal System:
- Gastroparesis: Delayed stomach emptying, which can cause nausea, vomiting, bloating, and a feeling of fullness after eating small amounts of food.
- Constipation or Diarrhea: Autonomic neuropathy can cause irregular bowel movements, leading to either constipation or diarrhea. Some people experience alternating episodes of both.
- Swallowing Difficulties: Nerve damage can impair the muscles that control swallowing.
Urinary System:
- Bladder Dysfunction: Difficulty emptying the bladder completely (urinary retention) or frequent urination due to overactive bladder. This can increase the risk of urinary tract infections (UTIs).
- Incontinence: Loss of bladder control, leading to urinary incontinence.
Sweating and Temperature Regulation:
- Sweating Abnormalities: Some people experience reduced or absent sweating (anhidrosis), leading to difficulty regulating body temperature. Others may experience excessive sweating (hyperhidrosis).
- Heat Intolerance: Reduced ability to sweat may make it difficult to tolerate hot temperatures, leading to overheating or heat exhaustion.
Sexual Function:
- Erectile Dysfunction: In men, autonomic neuropathy can cause difficulty achieving or maintaining an erection.
- Sexual Dysfunction in Women: Women may experience vaginal dryness or difficulties with sexual arousal and orgasm.
Pupillary Response:
- Vision Problems: Autonomic neuropathy can affect the nerves that control the pupils, leading to difficulty adjusting to light or darkness (pupil dilation issues), which may cause problems with night vision or sensitivity to bright lights.
Hypoglycemia Unawareness (in people with diabetes):
- People with diabetic autonomic neuropathy may lose the ability to feel the symptoms of low blood sugar (hypoglycemia), such as shakiness, sweating, or heart palpitations. This can be dangerous because they may not realize they need to take action to raise their blood sugar.

Diagnosis of Autonomic Neuropathy:

Diagnosing autonomic neuropathy involves a combination of medical history, physical examination, and specific tests to evaluate the function of the autonomic nervous system. Common diagnostic tools include:

Tilt Table Test:
- This test measures how blood pressure and heart rate respond to changes in position (from lying down to standing up) and is commonly used to diagnose orthostatic hypotension.
Heart Rate Variability:
- This test measures changes in heart rate during deep breathing or with physical activity, assessing the function of the nerves that control heart rate.
Gastric Emptying Test:
- This test evaluates how quickly food moves from the stomach into the small intestine, helping to diagnose gastroparesis.
Bladder Function Tests:
- Urodynamic tests may be used to evaluate bladder function and assess for urinary retention or overactive bladder.
Sweat Test:
- A quantitative sudomotor axon reflex test (QSART) or thermoregulatory sweat test (TST) can measure sweat production to assess for sweating abnormalities.
Blood Pressure Monitoring:
- Continuous blood pressure monitoring during activities like standing, exercising, or breathing exercises can help detect abnormal blood pressure responses.
Pupil Exam:
- A simple eye exam can reveal abnormalities in pupil dilation, which may suggest autonomic dysfunction affecting the eyes.
Blood Tests:
- Blood tests can help identify underlying causes, such as diabetes, vitamin deficiencies, or infections.

Treatment of Autonomic Neuropathy:

There is no cure for autonomic neuropathy, but treatment focuses on managing the underlying cause, relieving symptoms, and improving quality of life. Treatment approaches include:

Managing Underlying Conditions:
- For people with diabetes, controlling blood sugar levels is crucial in preventing further nerve damage and managing symptoms.
- For autoimmune diseases or infections, treating the underlying condition can reduce the progression of nerve damage.
Medications:
- Blood Pressure Medications: For orthostatic hypotension, medications like midodrine or fludrocortisone can help raise blood pressure.
- Prokinetics: Drugs like metoclopramide can improve gastric emptying in people with gastroparesis.
- Bladder Medications: Medications may be prescribed to manage overactive bladder or urinary retention.
- Erectile Dysfunction Medications: Drugs like sildenafil (Viagra) can help men with erectile dysfunction.
- Antidiarrheal Medications: Loperamide or other medications may be used to control diarrhea, while stool softeners or laxatives may help with constipation.
Lifestyle Modifications:
- Dietary Changes: For gastroparesis, eating smaller, more frequent meals, avoiding high-fiber and high-fat foods, and drinking plenty of fluids can help improve digestion.
- Elevating the Head of the Bed: This can help reduce the effects of orthostatic hypotension by preventing blood from pooling in the legs.
- Compression Stockings: These can help improve blood circulation and prevent blood pressure drops when standing.
- Bladder Training: Regularly timed bathroom visits and pelvic floor exercises may help manage bladder dysfunction.
Physical Therapy and Exercise:
- Physical therapy and regular exercise can improve circulation, help manage orthostatic hypotension, and prevent muscle atrophy. Exercise may also help with digestion and blood pressure regulation.
Assistive Devices:
- Compression garments, mobility aids, or adaptive equipment for managing bladder issues may improve daily functioning.

Prognosis:

The outlook for people with autonomic neuropathy depends on the underlying cause, the extent of nerve damage, and how well symptoms are managed. For some people, symptoms may stabilize or improve with treatment. For others, especially those with progressive conditions like diabetes or autoimmune diseases, autonomic neuropathy may worsen over time. Early diagnosis and proper management can improve quality of life and help prevent complications.

Conclusion:

Autonomic neuropathy is a form of nerve damage that affects the autonomic nervous system, leading to a wide range of symptoms related to involuntary body functions. The condition can result from diabetes, autoimmune diseases, infections, or other factors. While there is no cure, managing the underlying condition and treating symptoms can help individuals with autonomic neuropathy improve their quality of life.

Jodi Knapp