Autonomic Neuropathy: A Full Definition

Today's post from newyorktimes.com (see link below) gives a simple, general explanation for what autonomic neuropathy is. Sometimes, when presented with a diagnosis, all you want is a simple description of what you're dealing with, that you can read at your leisure after you've left the doctor's office. This give you just that. Please remember, you can have neuropathy (peripheral or otherwise) and still go on to develop autonomic neuropathy at a later date. It's not something that happens overnight but is a gradual accumulation of symptoms over a period of time. It's always worthwhile keeping a medical diary (while realising how easy it is to become obsessed!) then you will have a better overview to present to your doctor when necessary.

Autonomic Neuropathy
The New York Times Health Reference from A.D.A.M. Saturday, April 19, 2014

Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that manage every day body functions such as blood pressure, heart rate, sweating, bowel and bladder emptying, and digestion.
  
Alternative Names

Neuropathy - autonomic; Autonomic nerve disease

Causes

Autonomic neuropathy is a group of symptoms, not a specific disease. There are many causes.

Autonomic neuropathy involves damage to the nerves that carry information from the brain and spinal cord to the heart, bladder, intestines, sweat glands, pupils, and blood vessels.

Autonomic neuropathy may be seen with:
Alcohol abuse
Diabetes (diabetic neuropathy)
Disorders involving scarring of tissues around the nerves
Guillain Barre syndrome or other diseases that inflame nerves
HIV and AIDS
Inherited nerve disorders
Multiple sclerosis
Parkinson's disease
Spinal cord injury
Surgery or injury involving the nerves

Symptoms

Symptoms vary depending on the nerves affected. They usually develop gradually over years. Symptoms may include:

Stomach and intestines
Constipation (hard stools)
Diarrhea (loose stools)
Feeling full after only a few bites (early satiety)
Nausea after eating
Problems controlling bowel movements
Swallowing problems
Swollen abdomen
Vomiting of undigested food

Heart and lungs
Abnormal heart rate or rhythm
Blood pressure changes with position and causes dizziness when standing
High blood pressure
Shortness of breath with activity or exercise

Bladder
Difficulty beginning to urinate
Feeling of incomplete bladder emptying
Leaking urine

Other
Sweating too much or not enough
Heat intolerance brought on with activity and exercise
Sexual problems including erection problems in men and vaginal dryness and orgasm difficulties in women
Small pupil in one eye
Weight loss without trying

Exams and Tests

Signs of autonomic nerve damage are not always seen when yourdoctor or nurse examines you. Your blood pressure or heart rate may change when lying down, sitting, and standing.

Special tests to measure sweating and heart rate may be done. This is called "autonomic testing."

Other tests depend on what type of symptoms you have.

Treatment

Treatment to reverse nerve damage is most often not possible. As a result, treatment and self-care are focused on managing your symptoms and preventing further problems.

Your doctor or nurse may recommend:
Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels
Fludrocortisone or similar medications to help your body retain salt and fluid
Medicines to treat irregular heart rhythms
Pacemaker
Sleeping with the head raised
Wearing elastic stockings

The following may help your intestines and stomach work better:
Daily bowel care program
Medications that increase gastric motility (such as Reglan)
Sleeping with the head raised
Small, frequent meals

Medicines and self-care programs can help you if you have:
Urinary incontinence
Neurogenic bladder
Erection problems

Outlook (Prognosis)

How well you do depends on the cause of the problem and if it can be treated.
 
Possible Complications
Fluid or electrolyte imbalance such as low blood potassium (if excessive vomiting or diarrhea)
Injuries from falls (with postural dizziness)
Kidney failure (from urine backup)
Malnutrition
Psychological/social effects of impotence

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of autonomic neuropathy. Early symptoms might include:
Becoming faint or lightheaded when standing
Changes in bowel, bladder, or sexual function
Unexplained nausea and vomiting when eating

Early diagnosis and treatment increases the likelihood of controlling symptoms.

Autonomic neuropathy may hide the warning signs of a heart attack. They are sudden fatigue, sweating, shortness of breath, nausea, and vomiting.

Prevention

Preventing or controlling disorders associated with autonomic neuropathy may reduce the risk. For example, people with diabetes should closely control blood sugar levels.

References

Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine . 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 446.

Benarroch E, Freeman R, Kaufman H. Autonomic nervous system. In: Goetz CG, eds. Textbook of Clinical Neurology . 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 21.

Chelimsky T, Robertson D, Chelimsky G. Disorders of the Autonomic Nervous System. In: Daroff: Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia,Pa; Elsevier; 2012: chap 77.

http://www.nytimes.com/health/guides/disease/autonomic-neuropathy/overview.html