What Is Autonomic Neuropathy?
Autonomic neuropathy is a group of conditions caused by damage to your nerves. It can lead to many different symptoms, like dizziness, night sweats, and constipation.
Nerves are part of your autonomic nervous system. They control many different body functions, including:
- Body temperature
- Blood pressure
- Heart rate
- Digestion
- Urination
- Bowel movements
Symptoms of Autonomic Neuropathy
Your symptoms will depend on where the damaged nerves are and which organs are involved. They can include:
Digestive symptoms:
- Loose bowel movements (diarrhea)
- Hard bowel movements (constipation)
- Feeling less hungry or full after only a few bites of food
- Nausea
- Throwing up undigested food
- Trouble swallowing
- Heartburn
Heart and blood vessel symptoms:
- Dizziness or fainting when you stand up
- Very fast heart rate, especially when you exercise
- High blood pressure
Urinary symptoms:
- Trouble starting to pee or lack of control over peeing
- A hard time emptying your bladder
- Urinary tract infections
Body temperature symptoms:
- Night sweats
- Sweating too much or too little
- Sweating while you eat
Sexual symptoms:
- Trouble getting an erection (in men)
- Dry vagin* (in women)
- Low sex drive
- Problems having an org*sm
Lung symptoms:
- Shortness of breath
Visionsymptoms:
- Trouble adjusting between a bright room and a dark one
Causes of Autonomic Neuropathy
Damage to nerves affects the signals between your brain and your organs. Certain diseases and treatments related to your nerves can cause it -- diabetes is the most common one. Other possibilities include:
- Abnormal protein buildup, called amyloidosis
- Autoimmune diseases like rheumatoid arthritis, Guillain-Barré syndrome, lupus, and Sjogren's syndrome
- Lyme disease
- HIV
- Parkinson's disease
- Inherited diseases such as Riley-Day syndrome
- Spinal cord injury
- Surgery
- Medicines, including some chemotherapy drugs used to treat cancer
- Chemicals, like acrylamide, and heavy metals
- Heavy alcohol use
- Multiple sclerosis
- Botulism
- Medications, such as chemotherapy for cancer
Autonomic Neuropathy Diagnosis
Your doctor will ask about your symptoms and do a physical exam. They also might recommend blood tests to check for:
- Diabetes
- Sjogren's syndrome and other autoimmune diseases
- Infections like HIV or Lyme disease
Other tests you might have include:
- Tilt-table test. You’ll lie on a table, and it will tilt to raise part of your body as if you were standing. Your doctor will watch your blood pressure and heart rate as your position changes.
- Quantitative sudomotor axon reflex test. This uses a small electrical current to see how your sweat glands are working.
- Urodynamic tests. These check how well your bladder stores and releases urine.
- Ultrasound.This uses high-frequency sound waves to make images of your bladder so your doctor can get a better look at what’s happening.
- X-rays.
- Gastric emptying test. This test checks you for signs of irregular digestion, like slow digestion or slower stomach emptying (gastroparesis).
- Thermoregulatory sweat test. This test looks for any irregular patterns in how you sweat. Your body is covered in powder that changes colors as the temperature slowly rises inside a special chamber.
Autonomic Neuropathy Treatment
Your doctor mainly will treat the disease that caused your nerve damage. For example, if you have diabetes, you'll need to control your blood sugar with diet, exercise, and possibly medicine. For autoimmune diseases, like Sjogren's syndrome, you'll get medicine to control your immune system and bring down inflammation in your body.
Your doctor also might recommend other things to ease specific symptoms.
To treat digestive symptoms:
- Change your diet. Eat smaller meals so you don’t feel too full. Add fluid and fiber to your diet to prevent bloating and constipation.
- Laxatives can help with constipation, and other medicines can treat diarrhea and belly pain.
- Sleep with the head of your bed raised to prevent heartburn.
To treat urinary symptoms:
- Drink fluids and empty your bladder at set times during the day. This can help your bladder hold more fluid.
- Oxybutynin (Ditropan XL) and tolterodine (Detrol) stop your bladder muscle from squeezing too often. Bethanechol helps you empty your bladder all the way.
- Use a catheter. This tube goes into your bladder to help empty it.
To treat sweating problems:
- A few drugs can help you make less sweat, including glycopyrrolate (Robinul, Robinul Forte) and botulinum toxin.
- If you don't sweat enough, stay inside when it's hot outdoors.
To treat heart and blood pressure symptoms:
- Take a medicine that raises your blood pressure, such as fludrocortisone or midodrine and pyridostigmine (Mestinon).
- Take medicine to control your heart rate. Beta-blockers can help bring your heart back into a normal rhythm.
- Stand up slowly so you don't get dizzy.
- Get extra salt and fluid in your diet to help raise your blood pressure. Only do this if your doctor recommends it. In some cases, it can raise your blood pressure too high or cause swelling.
To treat sexual symptoms:
- Drugs like sildenafil (Revatio, Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn) can help men get -- and keep -- an erection.
- Women can try a water-based lubricant to make sex more comfortable.
- Men may use an external vacuum pump to pull blood into the penis to have an erection.
- Premenopausal women with low sexual desire may try the drug flibanserin (Addyl).
