What is autonomic neuropathy

Autonomic neuropathy occurs when the nerves that control involuntary body functions are damaged, which can affect blood pressure, temperature regulation, digestion and bladder and sexual function. These nerve damage interfere with communication between the brain and other organs, and can affect multiple systems, such as cardiovascular, gastrointestinal, genitourinary, among others.

In most cases, diabetes is the disease that causes autonomic neuropathy and can rarely be caused by other factors. Treatment depends on the cause of the disease and usually consists of symptom relief.

Possible causes

The most common cause of autonomic neuropathy is diabetes, when there is no adequate glucose control, which can gradually cause nerve damage.

Although more rare, autonomic neuropathy can still be caused by:

  • Amyloidosis, which affects the organs and the nervous system. Learn how to identify amyloidosis;
  • Autoimmune diseases, whose immune system attacks the body itself, including, in this case, nerves;
  • Medicines, mainly those used in cancer chemotherapy treatments;
  • Infectious diseases, such as botulism, HIV or Lyme disease;

In addition, autonomic neuropathy can also be triggered by some inherited diseases.

What are the signs and symptoms

Autonomic neuropathy can involve the cardiovascular, digestive, urogenital, sweat and pupillary motricity systems.

The signs and symptoms that may occur in people with autonomic neuropathy will depend on the nerves that have been affected and may include dizziness and feeling faint, caused by a drop in blood pressure, urinary incontinence, difficulty in emptying the bladder completely, difficulty in maintaining a bladder. erection or reaching orgasm, reduced sexual desire, gastrointestinal disorders such as diarrhea, feeling full, nausea and vomiting.

In addition, in some cases, the body may find it difficult to recognize hypoglycemia, to adjust the temperature, to adapt the eye to light or dark places and difficulty to adapt the heart rate to physical exercise.

Autonomic neuropathy can significantly compromise the quality of life of diabetic patients. Generally, this disease appears in diabetics who have had this disease for a long time.

How to prevent

Autonomic neuropathy can be prevented with adequate control of blood sugar levels, avoiding excessive alcohol consumption and smoking, performing the proper treatment of autoimmune diseases, controlling hypertension and maintaining a healthy lifestyle.

How the treatment is done

Treatment is essentially symptomatic and must also address the cause of the problem, that is, in the case of diabetes, it is also necessary to control the disease.

1. Orthostatic hypotension and tachycardia at rest

Abrupt postural changes should be avoided, compression socks or pants should be used and the head of the bed should be raised approximately 30 cm. In more severe cases, it may be necessary to use a medication to increase blood pressure, fludrocortisone, and perform a diet rich in salt and fluids.

If the person suffers from tachycardia at rest, the doctor may prescribe medications to regulate the heart, such as beta-blockers.

2. Gastrointestinal problems

If the person suffers from digestion problems, nausea and vomiting, the doctor may prescribe medications that relieve symptoms, such as metoclopramide, cisapride and domperidone.

In case of diarrhea, the doctor may prescribe loperamide and if the person suffers from constipation, it may be necessary to use laxative medications. In some cases of diarrhea, the doctor may prescribe broad-spectrum antibiotics to limit the proliferation of pathological bacteria in the intestine.

3. Urinary problems

To empty the bladder, the doctor may recommend complete bladder emptying with abdominal compression and self-probing maneuvers, which must be performed by a healthcare professional, or medications that help to empty the bladder.

If urinary infections occur or in situations where prevention is warranted, the doctor may prescribe antibiotics.

4. Sexual impotence

The first choice to treat sexual impotence includes medications such as sildenafil, vardenafil and tadalafil, which help maintain an erection. In the case of women who have decreased sexual desire and vaginal dryness, the use of a lubricant may be recommended.