Indigestion & Constipation
The autonomic nervous system of the gastrointestinal tract (the so-called "second brain") regulates food transport and digestive functions. In conjunction with the other symptoms but also as the only complaint, chronic constipation or an irritable bowel may indicate a disturbed abdominal brain. The diagnosis of a neurogenic disorder in food transport or digestion requires neurological and gastroenterological examinations. The search for a treatable cause of irritable bowel syndrome, diarrhea or constipation is sometimes successful only in collaboration with various medical disciplines such as rheumatology or endocrinology. The success of the treatment lies in the combination of dietary and behavioral recommendations as well as digestive support. Secondarily, medications can be used to improve digestion and relieve symptoms. These are carefully selected in the knowledge of the examination findings.
Nerves control gastrointestinal function
The gastric and intestinal activity relies on reflexes transmitted through the enteric nervous system, i. the nervous system of the intestine is mediated and controlled by the vagus nerves and impulses of the sympathetic nerves. The upper gastrointestinal tract (GI tract) from the esophagus to the small intestine is controlled by the brainstem, the vagus nucleus and its nerve tract. In the lower part, namely in the small intestine and large intestine, the peristalsis, i. the food transport is kept going by local enteric reflexes. Sympathetic nerve impulses, which are transmitted to the intestine by the switch points located next to the spinal cord, can stop the intestinal movements.
The perturbation of the passage through the esophagus is typically associated with a pressure sensation behind the sternum. It may be accompanied by a feeling of swallowing. Delayed gastric emptying may cause premature satiety, bloating but also abdominal pain. As a result of disturbed food transport through the esophagus or as a result of delayed gastric emptying, the appetite is also reduced. There may even be an aversion to food.
The disturbance of the intestinal passage may on the one hand with constipation (constipation) on the other hand, but also accompanied by an accelerated intestinal passage, frequent defecation and diarrhea (diarrhea). If constipation and diarrhea recur with no apparent trigger and can not be explained with the help of colonoscopy and imaging examinations of the intestine, so must also be thought of a neurological cause. Constipation and diarrhea, for example, may occur alternately as part of an irritable bowel syndrome.
Neurological causes of disturbed digestion
Neurological causes of gastric and intestinal function in the context of neuropathy (polyneuropathy) are not uncommon. Often these are not just stomach or intestines. The perception of sensitive stimuli in the legs or arms can be reduced. There may be discomfort of the feet or hands. The muscle power can generally be reduced. Careful investigations of the nerve tracts indicate, for example, disorders of nerve conduction in the legs and / or arms. Additional disorders of bladder function, circulatory regulation, sleep or sweating are not uncommon.
Diseases of the central nervous system may also be accompanied by disturbances of stomach and bowel functions. Particular attention in this context applies to neurodegenerative diseases such as Parkinson's disease. Already at an early stage, not infrequently years before the onset of Parkinson's disease, sufferers may suffer from frequent constipation and constipation. Some forms of dementia can be associated with disorders of bowel function. As a result of a disease of the central nervous system, disorders of the stomach and intestine often persist chronically. It's not just weight loss that can affect your physical fitness. Also, the absorption and timely effect of drugs can be disturbed by a decreased activity of the stomach or intestine (for example, gastroparesis or a pseudo-obstruction).
Diagnostics and treatment
The diagnosis of delayed gastric emptying, constipation or irritable bowel may be costly. If, by means of standard examinations such as gastric and colonoscopy, inflammation or passage obstacles in the stomach or intestine are excluded, the search for the causes of the digestive disorder also addresses, among other things, the neurological causes of disturbed food transport. The contrast-enhanced X-ray examination of the gastric and intestinal transit time as well as the measurement of esophageal pressure allow experienced gastroenterologists to assess the control and control of gastric and intestinal transit. The collaboration with neurogastroenterologists allows to include specialized examinations of the gastrointestinal functions in diagnostics and also to detect rare diseases.
Of course, our treatment recommendations are based primarily on the cause of disturbed stomach and intestinal functions. In addition, proven recommendations for nutrition, nutritional supplements and, above all, optimization of the gastric and intestinal transit are given. After careful selection, medicines are used to improve digestion and relieve symptoms.
Patients recalled the following experiences
"I had the feeling that every bite got stuck before my stomach. Eating had become a tedious and time-consuming job for me. I am glad that neurologists and gastroenterologists were able to search together and help me. "
„You have questions about ANS Clinic or would like to make an appointment? I'm happy to help.“
Prof. Dr. Med. Christina Haubrich