Treatment:

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

Various strategies may be used to reduce symptoms of light-headedness or dizziness when standing. These include:

• Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels
• Fludrocortisone or similar medications to help your body retain salt and fluid
• Sleeping with the head raised
• Wearing elastic stockings

Treatments for reduced gastric motility include:

• Medications that increase gastric motility (such as Reglan)
• Sleeping with the head raised
• Small, frequent meals

Diarrhea, constipation, bladder problems, and other symptoms are treated as appropriate. See: Bowel retraining and Neurogenic bladder for information about treatment of these conditions.

Phosphodiesterase type 5 (PDE-5) drugs, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) may be used for treating impotence. Discuss the use of these medications with your doctor.

Expectations (prognosis):

The outcome varies. If the cause can be found and treated, there is a chance that the nerves may repair or regenerate. The symptoms may improve with treatment, or they may continue or get worse, even with treatment.

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

Complications:

• Fluid or electrolyte imbalance such as low blood potassium (if excessive vomiting or diarrhea)
• Injuries from falls (with postural dizziness)
• Kidney failure (from urine backup)
• Malnutrition
• Psychological/social effects of impotence

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of autonomic neuropathy. Early symptoms might include:

• Becoming faint or lightheaded when standing
• Changes in bowel, bladder, or sexual function
• Unexplained nausea and vomiting when eating

Early diagnosis and treatment increases the likelihood of controlling symptoms.