What is Peripheral Autonomic Neuropathy?
Autonomic refers to the system of involuntary functions of the body. PAN may affect sexual, urinary, gastrointestinal, heart, blood pressure, vision or other involuntary functions that are controlled by the autonomic nervous system. In people with healthy autonomic nervous systems, the brain sends signals to the organs to perform various functions. In people with PAN, there is interference with those signals that the brain sends, which means that there are improper functions. It is similar to the idea of a person trying to tell another person some important instructions in a noisy room. Since the listener cannot hear well, the instructions may not be carried out properly.
Inadequate function of the autonomic nervous system can lead to these types of problems:
- Improper regulation of blood pressure.
- Improper regulation of body temperature.
- Improper digestive function.
- Improper heart function.
- Improper bladder and sexual function.
Each of these problems can come with another set of complications. For one example, when there is improper regulation of temperature, it can inhibit the work of sweat glands. This often leads to dry and cracked skin on the feet, which can lead to the development of sores. For diabetics, sores can be especially troublesome. If they heal, they take longer. Some sores may not heal and may lead to severe infections. As people age, their risk for developing this type of neuropathy increases. Also, the risks of complications increase when there are multiple risk factors, such as advancing age, previous surgeries and diabetes.
Symptoms of Peripheral Autonomic Neuropathy
Not all patients show the same signs or experience the same symptoms. Also, the severity and frequency of symptoms may vary from one patient to another. Symptoms may be tied to the stage of the disease as well. At first, symptoms are often minimal and may be mild enough that victims do not feel the need to discuss them with a doctor. In addition to the possible abnormal function of the sweat glands, these are some other potential symptoms:
- Orthostatic hypotension, dizziness or fainting that is due to a sudden drop in blood pressure.
- Urinary incontinence, frequent urinary tract infections, difficulty emptying the bladder or a sensation of a full bladder.
- Erectile dysfunction, ejaculatory problems, vaginal dryness, low libido or other sexual difficulties.
- Gastroparesis, reduced appetite or a feeling of nausea after eating.
- Bloating, heartburn and chest pain from digestive dysfunction.
- Constipation or diarrhea from improper gastrointestinal function.
- Slow pupil reaction, difficulty seeing at night and difficulty with the eyes adjusting between sudden changes of light and dark.
- Intolerance to exercise because of improper heart rate regulation.
Due to a lack of irregular blood sugar symptoms, there may also be an inability to detect serious changes. Since it is rarely possible to reverse the nerve damage when symptoms are noticeable, PAN is considered a lifelong disease. Treatments and therapies are designed to help patients manage symptoms and prevent dangerous complications from autonomic dysfunction.
Treatment for Peripheral Autonomic Neuropathy
For people with injuries, surgeries or certain diseases, it may be hard to prevent PAN. It often develops from damage to the small blood vessels that nourish nerves. People with diabetes can lower their risks of developing it by managing their health. Also, people who consume alcohol can reduce their risks by giving up alcohol.
Depending on the symptoms of a patient, treatment will vary. There are medications and treatments to help patients with deficiencies. These are some common examples of treatments for PAN:
- Diet changes or medications to help with gastrointestinal issues, such as diarrhea and heartburn.
- Catheter insertion, bladder training, medication or another treatment for bladder issues.
- Medications or sexual aids for sexual dysfunction.
- Medications and diet changes to stabilize blood pressure and heart rate issues.
- Surgery or medications to remedy issues with sweating.
Also, treatments can vary based on health history. For example, diet recommendations for someone who is an older diabetic would likely differ from the recommendations for someone who has multiple food intolerances. Since a treatment is intense and a multi-faceted issue, every PAN patient should work with a dedicated health care team.
