What is Autonomic Neuropathy?
Autonomic neuropathy is a medical condition where there is damage to the nerves which are responsible for controlling the involuntary functions of the body. The damage to the nerve hinders the messages which are transmitted between the brain and other organs. Autonomic neuropathy can affect the patient’s blood pressure, digestion, temperature control, bladder function and can also disrupt sexual function. Common cause of autonomic neuropathy is diabetes. Other causes include various medical conditions and some medications which cause nerve damage. Symptoms and treatment of autonomic neuropathy depend on the nerves that are damaged.
What are the Causes of Autonomic Neuropathy?
Diabetes is the commonest cause of Autonomic Neuropathy. However, other health conditions can also cause autonomic neuropathy. Certain medications can also cause autonomic neuropathy as their side effect. Causes of Autonomic Neuropathy are:
Diabetes which causes gradual nerve damage.
Autoimmune diseases, such as systemic lupus erythematosus, Sjogren’s syndrome, celiac disease, rheumatoid arthritis and Guillain-Barre syndrome where damage can occur to the autonomic nerves.
Amyloidosis where there is abnormal accumulation of protein in the organs leading to nerve damage and organ damage.
Some cancers such as paraneoplastic syndrome can also cause autonomic neuropathy.
Any injury or trauma to the nerves can also lead to autonomic neuropathy.
Certain medications especially which are used in chemotherapy to treat cancer can also cause autonomic neuropathy.
Chronic illnesses, such as multiple sclerosis, Parkinson’s disease and some forms of dementia can also cause autonomic neuropathy.
Infectious diseases, such as Lyme disease, botulism and HIV can also lead to autonomic neuropathy.
Some inherited disorders can also cause autonomic neuropathy.
What are the Risk Factors for Autonomic Neuropathy?
Poorly controlled diabetes is a major risk factor of autonomic neuropathy. Diabetics who have hypertension or are obese are at increased risk for developing autonomic neuropathy. Other diseases such as porphyria, amyloidosis, cancer and hypothyroidism also increase the risk of developing autonomic neuropathy.
What are the Symptoms of Autonomic Neuropathy?
Symptoms of autonomic neuropathy depend on the nerves that are affected and include:
- Dizziness and fainting upon standing (orthostatic hypotension).
- Problems with urination, such as difficulty in urination, difficulty in sensing a full bladder, incontinence, and incomplete emptying of the bladder. All these problems can cause urinary tract infections.
- Digestion problems, such as loss of appetite, feeling full after eating little food, diarrhea, bloating, constipation, nausea, difficulty swallowing, vomiting and heartburn.
- Sexual difficulties which consist of ejaculation problems or erectile dysfunction in men; and low libido, vaginal dryness and problems in achieving orgasm in women.
- Excessive sweating or sweating too little, which disturbs the regulation of the body temperature.
- Sluggish pupil reaction, due to which patient has difficulty in adjusting from light to dark and finds it difficult to see well when driving at night.
- Exercise intolerance, where the patient’s heart rate does not adapt to the activity level.
It is imperative to seek immediate medical attention if a diabetic patient is experiencing the above mentioned symptoms. It is also highly recommended that patients who have diabetes undergo annual autonomic neuropathy screening.
How is Autonomic Neuropathy Diagnosed?
Patient’s medical history and physical exam is done to assess the risk factors for Autonomic Neuropathy. Other tests which are done to diagnose Autonomic Neuropathy are: tilt table test, breathing tests, gastrointestinal tests, thermoregulatory sweat test, quantitative sudomotor axon reflex test, ultrasound and urodynamic tests.
How is Autonomic Neuropathy Treated?
Treatment of Autonomic Neuropathy consists of treating the underlying condition first. The aim of autonomic neuropathy is managing the disease which is causing the nerve damage. If the cause of Autonomic Neuropathy is diabetes, then it is important to have good control over the blood sugar to prevent worsening of autonomic neuropathy. Treatment of Autonomic Neuropathy also consists of managing the symptoms which depend on the part of the body affected by nerve damage.
Recommendations for Preventing Autonomic Neuropathy
- It is important to take good care of your health to prevent worsening of existing autonomic neuropathy.
- Exercise daily to prevent autonomic neuropathy or to prevent worsening of an existing autonomic neuropathy.
- Always keep a tight control on your blood sugar levels.
- Abstain from alcohol consumption.
- To prevent autonomic neuropathy, it is also important to control your blood pressure.
- Follow the right treatment if you are suffering from an autoimmune disease.
- Quit smoking.
- Maintain a healthy weight.
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