Autonomic neuropathy: treatment

Introduction
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By Aziz I Shaibani MD and Duaa Jabari MD

Autonomic neuropathy has numerous causes, some of them common, such as diabetic autonomic neuropathy, and others rare, such as Fabry disease, but all can produce disabling symptoms. Autonomic neuropathy can affect the sympathetic, parasympathetic, and enteric branches of the autonomic nervous system to variable degrees, causing dysfunction of different organs such as heart, intestinal tract, and urinary bladder. In this clinical summary, Dr. Aziz Shaibani of Baylor College of Medicine and Dr. Duaa Jabari of the University of Texas Houston Health Science Center review the available symptomatic treatments of these dysfunctions, focusing mainly on orthostatic hypotension, postural orthostatic tachycardia syndrome (POTS), gastroparesis, bladder hypomotility, and erectile dysfunction. A brief physiological and pathophysiological review and a discussion of available treatments are included for each disease discussed.

Key Points

  • Although autonomic neuropathy can be disabling, the patient's symptoms and quality of life can be improved efficiently.
  • In general practice, postural orthostatic tachycardia syndrome (POTS) can be easily overlooked.
  • New promising treatments are available for orthostatic hypotension, postural orthostatic tachycardia syndrome, and gastroparesis.

In This Article

Introduction
Orthostatic hypotension
Treatment of bowel hypomotility
Treatment of bladder hypomotility
Treatment of erectile dysfunction
References cited
Contributors