Treatment:

Treatment is supportive and may need to be long-term. Several treatments may be attempted before a successful one is found.

The use of elastic stockings and sleeping with the head elevated may reduce postural hypotension. Fludrocortisone or similar medications may be beneficial in reducing postural hypotension for some people. In severe cases, Proamatine may help prevent a drop in blood pressure when standing.

Medications that increase gastric motility (such as Reglan), small, frequent meals, sleeping with the head raised up, or other measures may be used to treat reduced gastric motility.

Impotence, diarrhea, constipation, bladder problems, and other symptoms are treated as appropriate. These symptoms may respond poorly to treatment.

Expectations (prognosis):

The outcome varies. If the cause can be identified and treated, there is a chance that the nerves associated with autonomic neuropathy may repair or regenerate. The symptoms may improve with treatment, or they may persist or worsen despite treatment.

Most symptoms of autonomic neuropathy are uncomfortable but they are seldom life threatening.

Complications:

• Fluid or electrolyte imbalance such as hypokalemia (if excessive vomiting or diarrhea)
• Malnutrition
• Kidney failure (associated with reflux of urine)
• Psychologic/social effects of impotence
• Injuries from falls (associated with postural dizziness)

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of autonomic neuropathy occur. Early diagnosis and treatment increases the likelihood of controlling symptoms.