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Neurology (Expert Forum)
Neuropathy/Constipation
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Neuropathy/Constipation
by yorkieville, Apr 01, 2007 12:00AM
I have Neuropathy and back pain & presssure, & am undergoing tests to determine the cause. Recently had a Sigmoidoscopy in hopes of determining the cause of my constipation. My Gastroenterologist said everything was normal, felt the constipation is related to the Neuropathy. How does Neuopathy cause it, and am I am danger of losing bowel function permanently?
Doctor's Answer
by Forum-M.D.-SH, Apr 22, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
Bowel motility is controlled by the autonomic nervous system. The Vagus nerve is the major player in providing parasympathetic output that produces GI motility. In patients with generalized neuropathy (most common cause is diabetes, but there are many others) or a specific neuropathy of the autonomic nervous system (such as pure autonomic failure) the nerve supply to the gut can be disturbed. A gastric emptying study will be helpful in determining if you have slow transit (likely due to decreased nerve supply). If this is the case, then promotility agents such as reglan or erthyromicin. I would also suggest a tilt table test and a battery of autonomiIc tests including heart rate response to deep breathing and pupillary response to light. I would also make sure you are not taking any narcotics for neuropathy related pain, narcotics are very constipating and not very effective on neuropathy pain. I would not expect you to loose bowel function completely, but I would expect that you will need to alter you diet to include more fiber/fiber supplements and may need promotility agents.
I hope this has been helpful.
Bowel motility is controlled by the autonomic nervous system. The Vagus nerve is the major player in providing parasympathetic output that produces GI motility. In patients with generalized neuropathy (most common cause is diabetes, but there are many others) or a specific neuropathy of the autonomic nervous system (such as pure autonomic failure) the nerve supply to the gut can be disturbed. A gastric emptying study will be helpful in determining if you have slow transit (likely due to decreased nerve supply). If this is the case, then promotility agents such as reglan or erthyromicin. I would also suggest a tilt table test and a battery of autonomiIc tests including heart rate response to deep breathing and pupillary response to light. I would also make sure you are not taking any narcotics for neuropathy related pain, narcotics are very constipating and not very effective on neuropathy pain. I would not expect you to loose bowel function completely, but I would expect that you will need to alter you diet to include more fiber/fiber supplements and may need promotility agents.
I hope this has been helpful.
Member Comments (13)
by Gracygirl, Apr 01, 2007 12:00AM
To: Yorkieville
I have had perhipral neuropathy for almost a full year with fluctations in pain, as well as constipation....my suggestion, try eating popcorn and a lot more roughage. The signals are all screwed up with neuropathy, however they do get through. I also noticed that taking a strong multivitamin everyday with iron has cause constipation as well, so I have started to take them every other day. You may want to check the vitamin bottle for iron content too. Hope this helps. May I ask how long you have been suffering with neuropathy and does your pain wax and wane?
by yorkieville, Apr 01, 2007 12:00AM
To: Gracygirl
The Neuropathy began in my legs, 3 years ago. Then, in 11/05, 5 months after a car accident, I began having low back pain and rectal pressure, constipation, etc. The back pain progressed to the point that I am unable to sit up for more than a few minutes without making the pain unbearable. Walking and standing also cause pain, and pressure on my lower spin. Then, in 12/06, the Neuopathy spread to my spine. In the past few months, I have lost the sensation to have a BM. My Gastroenterologist said my fiber intake is excellent, and I don't take a multivitamin. I am, however, taking 50 mg. of Lyrica twice a day now, and I am wondering if it could be causing the loss of sensation. The Lyrica has eased some of the back pain, so, that makes me think the pain is caused by the nerves. Tomorrow, I am scheduled to have a Lumbar Epidural Steroid Injection, as a diagnositc measure, to enable my Pain Management Doctor to determine what direction he should take. Thank you for taking the time to reply. It is all very scary, isn't it?
by Gracygirl, Apr 01, 2007 12:00AM
To: Yorkieville
What caused your neuropathy?
by yorkieville, Apr 01, 2007 12:00AM
To: Gracygirl
The doctors do not know, yet, what caused my Neuropathy. My new Pain Management Doctor is beginning tests and procedures, to hopefully, determine the cause. Tomorrow, I am having the Lumbar Epidural Steroid Injection, and he thinks that may reveal something. My D.O., whom I have been seeing once a month, for 3 years, has not been very serious about finding the cause, until I went in for my January appointment and told him that the nerves in my spine, began stinging in December. Then, he ordered an MRI, and in February, ordered an EMG, and with the results of both, referred me to the Pain Management Doctor, who is very concerned about getting me a diagnosis. He actually sat down in front of me, looked me in the eyes, and promised me that he would hold my hand and walk this path with me until I am diagnosed.
by Gracygirl, Apr 02, 2007 12:00AM
To: Yorkieville
Have you been able to walk the whole time? Did you ever lose your muscle strength in your legs completely? I would find a doctor that stays with you and helps you find a diagnosis. Three years is a long time to go without answers.
by yorkieville, Apr 02, 2007 12:00AM
To: Gracygirl
Yes, I have been able to walk, however, not for very long, because the back pain would become unbearable. I have lost muscle strength in my legs, and cannot feel the vibration in my feet and legs, when tested. I have lost 7#s and now weigh, 87#s at 5'2. Most of the weaght loss is along my spine. This afternoon, I had the Lumbar Epidural Steroid Injection. The Pain Management Doctor seemed a little doubtful that it will help, and will re-check me in two weeks. He injected dye and took an xray, so, I am curious to hear what he has to say.They say it takes time to see if the steroids ease the pain.
by jcverive, Apr 04, 2007 12:00AM
To: original poster
For a relatively simple biological function, bowel elimination is surprisingly complex. Absolutely everything that you swallow affects your bowels (even air, such as when chewing on gum). Drugs - prescription or not - can affect many of the physical factors (water balance, muscle tone, sensation, etc.), excercise affects metabolism, muscle tone, and certain physiological triggers (reflexes), and of course diet (what/when/how, and even where/why/how often you eat) has a great deal to do with bowel function. Even hormone balance and the physical