Autonomous neuropathy

Autonomous neuropathy refers to damage to the nerves within the autonomic nervous system. The heart, blood, sweat production and digestion are particularly affected. As a by-product of other diseases, autonomic neuropathy must be cured with therapy for the causative disease.

What is autonomic neuropathy?

Autonomic neuropathy is a nerve disorder that has undesirable effects on uncontrolled bodily functions, e.g. 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. As a result, abnormal phenomena in the uncontrolled body functions can occur. Autonomic neuropathy can be a byproduct of several disorders and conditions.

There are also medications in which autonomic neuropathy can 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 the specific case.

causes

Autonomic neuropathy can be a result of many disorders and diseases and a by-product of certain medications. Some common causes of autonomic neuropathy are:

Abnormal accumulation of proteins in organs (amyloidosis), which cause changes in organs and the nervous system; Autoimmune diseases that cause the own immune system to attack its own body cells (e.g. Sjögren's syndrome or lupus); 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; Medicines, especially cancer drugs (chemotherapy), antidepressants and heart drugs; other chronic diseases such as Parkinson's; some viruses and bacteria, i.a. Botulism, leprosy, diphtheria; congenital disorders can also lead to autonomic neuropathy.

Symptoms, ailments & signs

Depending on the disorder or disease underlying an autonomic neuropathy, the damage to the nerve can manifest itself through different symptoms and complaints. If an autoimmune disease is the cause, circulatory problems, palpitations and dizziness can occur. The increased susceptibility to infections can trigger infections and secondary diseases.

Edema can also 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 area, dry skin, flaking and increased sweating can occur. The respiratory tract is also often affected and can be irritated, which is noticeable through swallowing difficulties and inflammation, among other things.

Furthermore, the nerve damage can lead to temporary or permanent incontinence. Depending on the cause, other functional disorders can occur: paralysis, neurological complaints, organ dysfunction, restricted movement and poor posture. If the nerve damage is caused by cancer, there are external changes 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 determined on the basis of a comprehensive medical diagnosis. The symptoms mentioned can change in the course of the disease and increase in intensity.

Diagnosis & course

Many diseases and disorders can lead to autonomic neuropathy. For possible therapy, it is important to identify the cause of the nerve damage at the beginning.

Patients with diabetes or cancer belong to the risk group for autonomic neuropathy anyway. However, if the patient is not at risk, the diagnosis is more complicated and may include a number of other tests in addition to a personal medical history analysis and physical exam. A breath test, for example, can provide evidence of the heart rate and blood pressure being measured while the patient is doing 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. Further tests can check the function of the sweat glands or reveal malfunctions in the bladder, for example by means of an ultrasound.

Complications

As a rule, the autonomic neuropathy causes severe damage to the nervous system. This can affect the function of different organs or regions of the body. Above all, this includes the sweat glands, digestion and the heart. Those affected also suffer from diabetes with the disease.

Serious diseases of the cardiovascular system develop, so that the patient suffers from heart problems. These can show up in different forms, so that, for example, a racing heart can occur. Likewise, the person concerned can often no longer perform any physical activities and is therefore severely restricted in his everyday life.

Flatulence and diarrhea also occur. In addition, most patients also experience nausea and vomiting. If the disease occurs as a result of cancer, treatment is not always possible, so that in the worst case scenario, death can result. The treatment itself always depends on the underlying disease.

If it is started early, the nerve damage may recede, 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 drugs. The sweat glands can also be reactivated with the help of glycopyrronium bromide.

When should you go to the doctor?

If you have 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 as the disease progresses. Nausea and vomiting combined with dry skin and increased sweating suggest a serious illness. A doctor must clarify whether this is an autonomous neuropathy or another disease.

The risk groups include patients with diabetes, cancer or cardiovascular disease. Likewise smokers, overweight people and people with alcoholism. Anyone suffering from one of these diseases or ailments should speak to a doctor immediately if they have unusual symptoms. If the autonomic neuropathy is left untreated, it can become severe.

At the latest when chronic pain or fatigue occurs, a doctor must clarify the cause. Severe complaints such as chronic diarrhea, circulatory collapse or heart attacks are a medical emergency. The person concerned or an observer must call an ambulance service and, if necessary, carry out first aid measures.

Doctors & therapists in your area

Treatment & Therapy

Treatment usually does not directly address the autonomic neuropathy, but rather the disease causing it. As a consequence of many diseases, the nerve disorder will in most cases regress if the disease is successfully treated.

If the digestive tract is affected by the nerve disorder, your doctor will recommend diet changes to relieve symptoms. Certain medications can help make the diet move faster. If you have problems with your bladder, your doctor may recommend that you follow strict fluid intake and urination schedules. Drugs like bethanechol can help empty the bladder completely so that unwanted incontinence doesn't occur.

An overactive bladder is also possible and can be treated with medication. Men with autonomic neuropathy can complain of erectile dysfunction, which can be treated with Sildenafil. If a woman's vagina is too dry, lubricant can help. Effects on heart and blood pressure should also be controlled with the use of medication (e.g. midodrine and pyridostigmine). The agent glycopyrronium bromide can reduce the production of the sweat glands in the event of excessive perspiration.

Outlook & forecast

The prognosis of an autonomic neuropathy depends on the underlying disease. Often it is a chronic disease that cannot be cured.

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 the functionality of the organs are in the foreground. As autonomic neuropathy is not treated directly, no cure is expected. In addition, in many cases the damage to the nerves is irreparable.

The exchange or regeneration of nerve fibers has so far not been possible with the given scientific and medical methods. However, there is recovery in patients diagnosed with autonomic neuropathy if the underlying disease has been cured with medical treatment. This is particularly possible with diseases of the bladder or the digestive tract. After the overactive bladder has been healed, the neuropathy regresses automatically.

The prognosis prospects improve with adherence to a healthy lifestyle. With a balanced diet, the avoidance of harmful substances and a stable immune system, the patient's health improves significantly. The normal weight should be maintained and the needs of the organism should be taken into account.

prevention

Certain diseases favor the development of autonomic neuropathy. Here, patients must pay particular attention to their state of health and listen to the instructions of their doctor. With diabetes, blood sugar levels should be kept under control. Alcoholism must be combated, as must the smoking habit and exercise should be exercised regularly and a healthy body weight should be maintained.

Aftercare

The causes of autonomic neuropathy cannot be treated. Doctors can only alleviate the typical symptoms. A lifelong follow-up is therefore necessary. Since a large number of diseases can trigger autonomic neuropathy, the 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 intended to document the progress of the disease. Complications can also be excluded. Possible diagnostic procedures include imaging tests such as x-rays and sonography, EKG, blood tests and blood pressure measurements. In addition to medical support, the patient himself is responsible for his or her state of health. Both aspects equally determine the success of a treatment.

In principle, all health-promoting measures should be taken, including a balanced diet, avoiding addictive substances such as nicotine and alcohol and regular physical activity. If diabetes is present, it is essential to keep the blood sugar level low. Patients have to reduce excess weight.

Stress should also be avoided. Medicines are not infrequently administered as part of therapy. These are to be taken continuously. A withdrawal leads immediately to the strengthening of the symptoms. Those affected should pay attention to body signals and contact their doctor in the event of acute changes.

You can do that yourself

If type 2 diabetes mellitus is the trigger for autonomic neuropathy, the patient can best help himself by changing his lifestyle and eating habits. If you are significantly overweight, a weight loss of at least ten kilos is recommended. If weight 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 the intake of food; instead, a complete change in diet is required. Most of the time this project fails because of the necessary motivation or perseverance of the patient. The exchange with other affected persons in a self-help group is often very beneficial here.

If autoimmune diseases are the cause of autonomic neuropathy, patients should find out whether there is a connection between acute flare-ups of the autoimmune disease and certain external factors, for example certain foods or stressful situations, and avoid these factors as far as possible.

Individual symptoms of autonomic neuropathy can also be alleviated with mild home remedies. A teaspoon of cumin, chewed slowly, helps with flatulence. Dried blueberries, which are also very tasty, provide quick help with unspecific diarrhea. If you don't want to collect it yourself, you can buy it in the herb shop or order it online.