Symptoms:

Symptoms vary depending on the nerves affected. They usually develop gradually over years. Symptoms may include:

Gastrointestinal tract

• Constipation
• Diarrhea
• Feeling full after only a few bites (early satiety)
• Nausea after eating
• Swollen abdomen
• Vomiting of undigested food

Heart and lungs

• Blood pressure changes with position and causes dizziness when standing
• Shortness of breath with activity or exercise

Urinary tract

• Difficulty beginning to urinate
• Feeling of incomplete bladder emptying
• Urinary incontinence (overflow incontinence)

Other symptoms

• Abnormal sweating
• Heat intolerance brought on with activity and exercise
• Male impotence and ejaculation changes in men
• Vaginal dryness and orgasm difficulties in women
• Weight loss without trying

Signs and tests:

The doctor will perform a physical exam. A neurological exam may show evidence of injury to other nerves. However, it is very difficult to directly test for autonomic nerve damage.

Signs of autonomic neuropathy include:

• Abnormal sounds in the abdomen
• Decrease of blood pressure upon standing up (postural hypotension)
• Sluggish pupil reaction in the eye
• Swollen belly (abdomen)
• Swollen bladder

Other signs and symptoms that occasionally suggest a problem in the function of the autonomic nervous system include:

• Difficulty swallowing
• Excessive sweating
• Irregular heart rhythms
• High blood pressure
• Rapid or slow heart rate

Special measurements of sweating and heart rate are called "autonomic testing" and can assist in diagnosis and treatment.

Other tests include:

• Measurement of blood pressure lying down, sitting, and standing
• Measurement of changes in heart rate
• Upper GI
• Esophagogastroduodenoscopy (EGD)
• Isotope study
• Voiding cystourethrogram (VCUG) or other tests of bladder function

Other tests for autonomic neuropathy are based on the suspected cause of the disorder, as suggested by the history, symptoms, and the way symptoms developed.