What Is Autonomic Neuropathy?
Autonomic neuropathy is also known as autonomic dysfunction or dysautonomia. These refer to a variety of ailments that cause the autonomic nervous system or ANS to malfunction. The signals are exchanged between the brain and various organs, and parts of the autonomic nervous system are disrupted by nerve injury. The autonomic nervous system regulates biological functions such as breathing, temperature, blood pressure, digestion, and more. Autonomic neuropathy is a side effect of various drugs and can be a complication of several diseases.
What Is the Autonomic Nerve System’s Anatomy?
The blood vessels, liver, stomach, kidneys, heart, intestine, bladder, digestive glands, lungs, genitals, pupils, salivary glands, and sweat glands are all supplied by the autonomic nervous system. The autonomic nervous system is divided into two parts: sympathetic and parasympathetic. When the autonomic nervous system gets signals about the body and external environment, it reacts by inhibiting the body processes by the parasympathetic division of the autonomic nervous system and responds when the sympathetic division of the autonomic nervous system is activated.
What Is the Cause of Autonomic Neuropathy?
Autonomic neuropathy can be caused by a variety of medical disorders, and it can also happen to be a side effect of other disorders, such as cancer treatment. The following are some of the most common causes of autonomic neuropathy:
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The most prevalent cause of autonomic neuropathy known is diabetes, especially when it is poorly controlled. Diabetes can lead to nerve damage throughout the body over time.
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The immune system targets and damages components of the body, including the nerves, in autoimmune illnesses such as systemic lupus erythematosus, Sjogren's syndrome, rheumatoid arthritis, and celiac disease. Guillain-Barre syndrome is an autoimmune disease that affects the autonomic nervous system.
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Amyloidosis is an abnormal protein deposition in tissues that damages the organs and neurological system.
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Another probable reason is an immune system attack that happens as a result of some tumors, such as paraneoplastic syndrome.
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Certain treatments, including chemotherapy for cancer and anticholinergic drugs, viruses and bacteria that cause HIV, Lyme disease and botulism, and hereditary disorders, can all be the reason behind autonomic neuropathy.
What Are the Symptoms of Autonomic Neuropathy?
The symptoms of autonomic neuropathy differ depending on which nerves are impacted. They usually take years to develop.
Symptoms of the heart and lungs include:
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An abnormal heart rhythm or heart rate.
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The blood pressure is too high. Standing induces dizziness because the blood pressure changes with position.
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With exertion or exercise, individuals may experience shortness of breath.
Symptoms of the stomach and intestines include:
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Constipation or hard stool (a common complaint among people).
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Diarrhea or loose stool is a common problem.
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Problem controlling bowel motions.
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Nausea and early satiety after eating.
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Swelling in the abdomen.
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Problem experienced when swallowing and vomiting the undigested food.
Symptoms seen in the bladder include:
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Urine dripping.
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Having trouble when starting to urinate.
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Getting the feeling as if the bladder is not emptying completely.
Other signs and symptoms could include:
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Sweating excessively or insufficiently.
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Heat intolerance develops as a result of physical exertion and exercise.
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Erection problems in males, as well as vaginal dryness and orgasm issues in females.
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One eye has a small pupil.
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Weight loss without putting any effort.
How to Diagnose Autonomic Neuropathy?
The treatment process begins with a precise diagnosis of the signs and symptoms. A comprehensive history and physical examination focusing on the autonomic nervous system is needed to accomplish this. To aid with the diagnosis, specific testing of the autonomic nervous system is frequently required.
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The autonomic nerves that control sweating are measured with the quantitative sudomotor axon reflex test (QSART). The sweat glands are stimulated, and the volume of sweat produced is measured in this test. The QSART can be used to diagnose a variety of autonomic illnesses, including autonomic and small-fiber neuropathies, as well as various pain syndromes. The QSART is also useful in determining if the autonomic dysfunction is located in the peripheral or central neural systems.
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The cardiovascular autonomic test with tilt evaluates a patient's autonomic nervous system's ability to manage blood pressure and heart rate through several movements, including deep breathing, the Valsalva maneuver, and head-up tilt. These tests are very useful in evaluating people who have syncope or fainted.
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The thermoregulatory sweat test is a test that determines a patient's ability to sweat in a warm, humid environment. This exam evaluates the control of sweating and body temperature regulation by the central and peripheral autonomic nervous systems. This test's detection of abnormal sweating patterns can aid in the diagnosis of a range of neurological and autonomic illnesses.
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Gastric motility and muscular activity are assessed using gastric emptying assays.
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Urine testing to determine how well the bladder is working and abdominal X-rays to analyze the digestive tract.
How To Treat Autonomic Neuropathy?
The disease that produced the nerve damage will be the primary focus of the doctor's treatment. For example, if a patient has diabetes, they will need to keep their blood sugar under control through food, exercise, and potentially medication. They will be given drugs to manage the immune system and reduce inflammation in the body if the patient has an autoimmune condition like Sjogren's syndrome.
To relieve intestinal symptoms:
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Alter your eating habits. Smaller meals will keep the patients from feeling overly full.
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To avoid bloating and constipation, increase hydration, and fiber intake.
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Constipation can be relieved with laxatives, and diarrhea and stomach pain can be treated with additional medications.
To get rid of excessive sweating:
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Botulinum toxin and Glycopyrrolate are two medications that can help the patient sweat less.
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When it is hot outside, stay indoors if the patient does not sweat enough.
To treat urinary symptoms:
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Throughout the day, at regular intervals, drink fluids and empty the bladder. This can aid in the retention of fluid in the bladder.
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A catheter can be put into the bladder to aid in its emptying.
To alleviate blood pressure and heart symptoms:
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Control the heart rate with medication. Beta-blockers can assist in restoring your heart's regular rhythm.
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Take blood pressure medication.
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Slowly get up to avoid becoming dizzy.
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To assist in enhancing the blood pressure, include more salt and fluid in the diet, but only if advised by the doctor.
To relieve sexual discomfort:
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Medications can assist men in achieving and maintaining an erection.
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To make sex more comfortable, women can use a water-based lubricant.
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Flibanserin is a medication that can help premenopausal women with reduced sexual drive.
Conclusion:
Autonomic dysfunction can have a negative impact on daily activities, for example, exercise, generate bothersome symptoms, and even result in death. Because the patient's history and physical examination are poor in detecting early signs of autonomic nerve dysfunction, noninvasive diagnostics with proven efficacy should be used. Reduce the likelihood of neuropathy by preventing or controlling related illnesses. People with diabetes, for example, should keep a tight eye on their blood sugar levels.
