Autonomic Nervous System Disorders and Their Impact on Health

Autonomic nervous system dysfunction

Hello, Doctor! I have been experiencing discomfort in my anus for over six months, with persistent mild pain, itching, and a sensation of something being there.
I feel these symptoms constantly, except when I am asleep.
I have consulted many proctologists and even underwent hemorrhoidectomy, but the symptoms remain the same.
The proctologist told me that there is nothing wrong with my anus and advised me not to focus on it too much, as the more I think about it, the more uncomfortable I feel.
I also have mild anxiety and depression, and I am not interested in many things, only concerned about my condition.
Sometimes I experience insomnia, and some doctors have suggested that it might be somatization disorder or neurosis.
I previously had some health anxiety.
What should I do? Which type of doctor should I see?

Zeng Shenzhong, 30~39 year old female. Ask Date: 2017/04/10

Dr. Jiang Junyi reply Neurology

Hello, the autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems, one acts as the accelerator and the other as the brake.
The sympathetic nervous system is responsible for revving up the body, pushing it into action.
In contrast, the parasympathetic nervous system is responsible for slowing things down, allowing the body to rest.
During exercise, the sympathetic nervous system is activated, leading to an increased heart rate, faster breathing, and increased sweating.
Once the exercise stops, the parasympathetic nervous system takes over, which slows the heart rate, decreases breathing rate, and reduces sweating.
Therefore, many psychosomatic symptoms can be improved through moderate exercise.
It is recommended that you first consult a neurologist to discuss an evaluation and then work with a rehabilitation specialist in autonomic nervous system disorders to design an appropriate exercise prescription.
Wishing you good health, peace, and joy.
The Department of Neurology at Taoyuan Hospital cares about you.

Reply Date: 2017/04/10

More Info

Understanding autonomic nervous system (ANS) disorders and their impact on health is crucial, especially when symptoms persist despite medical interventions. Your experience of persistent discomfort in the anal region, accompanied by pain, itching, and a sensation of foreign body presence, can be quite distressing. It’s important to recognize that the ANS plays a significant role in regulating bodily functions, including those related to the gastrointestinal and excretory systems.

The autonomic nervous system is divided into the sympathetic and parasympathetic systems. The sympathetic system prepares the body for 'fight or flight' responses, while the parasympathetic system promotes 'rest and digest' activities. Dysregulation of the ANS can lead to various symptoms, including gastrointestinal issues, anxiety, and even chronic pain syndromes. In your case, the discomfort you are experiencing may be exacerbated by anxiety and stress, which can create a feedback loop of heightened awareness and discomfort in the affected area.

Given your symptoms and the history of multiple consultations with proctologists, it seems that a physical cause has been largely ruled out. The advice from your doctors to not focus excessively on the discomfort is rooted in the understanding that anxiety and hyper-awareness can amplify sensations of pain and discomfort. This phenomenon is often seen in patients with somatic symptom disorders, where psychological factors manifest as physical symptoms.

Your mention of mild anxiety and depressive symptoms is also significant. Anxiety can lead to increased muscle tension and heightened sensitivity to bodily sensations, which may explain why you continue to feel discomfort despite medical reassurance. Cognitive-behavioral therapy (CBT) is often recommended for individuals experiencing anxiety and somatic symptoms. CBT can help you reframe your thoughts about your symptoms, reduce anxiety, and improve your overall quality of life.

In terms of medical consultation, it may be beneficial to see a psychiatrist or a psychologist who specializes in somatic symptom disorders or anxiety disorders. They can provide you with coping strategies and therapeutic interventions that address both your psychological and physical symptoms. Additionally, a consultation with a pain management specialist may be helpful if your discomfort is chronic and significantly impacts your daily life.

Moreover, lifestyle modifications can also play a role in managing your symptoms. Regular physical activity, mindfulness practices, and relaxation techniques such as yoga or meditation can help reduce anxiety and improve your overall well-being. Ensuring that you maintain a healthy diet and stay hydrated can also support your gastrointestinal health.

In summary, while your symptoms may initially seem isolated to the anal region, they are likely influenced by a complex interplay of physical and psychological factors. Seeking help from mental health professionals, along with continued support from your primary care physician, can provide a comprehensive approach to managing your symptoms. Remember, you are not alone in this, and there are effective strategies and treatments available to help you find relief and improve your quality of life.

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