The Challenge of Treating Autonomic Neuropathy


:dropcap_open:O:dropcap_close:ne of the fastest growing surgical procedures in the United State is gastric bypass surgery or lap band placement.  With that increase comes a whole new patient population:  Patients suffering from the side effects of gastric bypass or lap band placement.  Chances are they were warned about the downside of the procedure they were planning to have, but it’s a safe bet they weren’t told about Gastrointestinal Autonomic Neuropathy.  And they’re in for a really unpleasant surprise.  If you have a post operative gastric bypass patient (or patient with a history of alcohol abuse, diabetes, hepatitis C, Crohn’s Disease or Celiac Disease) and they present with some or all of the following symptoms1 :heartburn

  • Heartburn
  • Bloating
  • Nausea and/or vomiting
  • Serious difficulty swallowing because their esophagus no longer functions properly
  • Inability to empty your stomach
  • Diarrhea or constipation

you could be dealing with a case of G.I. Autonomic Neuropathy.  If they’ve only started experiencing these new symptoms recently, congratulate them on getting in to see you quickly.  In order to lessen the chance of serious nerve damage and even permanent damage to their digestive system, they need a clinician specially trained in diagnosing and treating nerve disease and damage.

Helping Patients Understand G.I. Autonomic Neuropathy

Because they can’t see physical evidence of G.I. autonomic neuropathy (other than their terribly unpleasant symptoms), they probably think they’re experiencing routine side effects (if they’re a gastric bypass patient).  It’s important that your patient understands that G.I. Autonomic Neuropathy, in itself, is not a disease.  Explain to them that it’s a type of neuropathy that affects the nerves, specifically the vagus nerve that controls the digestive system. The nerves are damaged due to malnutrition and vitamin deficiency and don’t function properly.  Soon the body “forgets” how to digest food properly and their very unpleasant symptoms begin.

Aside from gastric bypass patients, Gastrointestinal Autonomic Neuropathy can be caused by other diseases or chronic medical conditions such as:

  • Diabetes
  • Alcoholism
  • Cancer
  • Crohn’s Disease
  • Celiac Disease

If your patient suffers from any of the above conditions or any number of other chronic illnesses, their chances of developing G.I. Autonomic Neuropathy are dramatically increased.  If they’re coming to you with any of the symptoms we discussed above, they may have developed autonomic neuropathy as a result of their underlying illness.

Treatment and Prognosis

If you use the correct protocols, you will find the treatment regimen ideally suited to treating all types of peripheral neuropathy, including G.I. Autonomic Neuropathy.  In fact, treatment protocols have been developed specifically for patients suffering from neuropathy.

G.I. Autonomic neuropathy is a chronic condition, but it can be treated and your patient can do things to help relieve their symptoms.  Work with the patient and any other physicians they’re seeing to treat the G.I. Autonomic Neuropathy and manage their underlying condition.  Explain to your patient that your treatment protocol was designed to treat the whole patient and not just their symptoms.  You can do this by offering:

healthyfoodDiet Planning and Nutritional Support

The body needs the proper the nutrition to heal.

If they have gastrointestinal issues caused by G.I. Autonomic Neuropathy, it might be tempting to increase their fiber intake beyond the recommended daily amount, but don’t.  This can cause the development of bezoars due to the inability of their digestive system to eliminate waste properly.  Provide them with a diet plan that ensures they get the right amount of fiber, whole grains, fresh vegetables, lean meats2 and drinking enough water.

If they have diabetes, work with them on a diet to control their blood sugar.

• Individually Designed Exercise Programs

Develop an exercise regimen for your patient that will allow them to take things slowly but still work some physical activity into their daily routine.  Treating neuropathy patients requires specialized training in the design and monitoring of exercise programs. You can be specially trained in designing exercise programs to meet the needs of the neuropathy patient.

• Lifestyle Modifications

Really study your patient’s lifestyle and monitor them for ways to help them live a healthier life.  Any type of stress management program will help them manage the depression that arises from such a debilitating condition.

Early intervention with a clinician well versed in treating all types of neuropathy is still the best course of action for a Gastrointestinal Autonomic Neuropathy patient.  While you can’t reverse your patient’s condition if they have already developed neuropathy, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.

When you’re trained and ready to work with them, let them know you’re there.

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