Autonomic Nervous System Disorders and Functional Gastrointestinal Issues

Q: Autonomic Nervous System Disorders and Functional Gastrointestinal Issues

Hello Johnson： <br>In response to your previous two emails regarding your current condition and to address your questions, there are no significant signs of gastric ulcers. <br>It can be confirmed that many of your gastrointestinal discomfort symptoms are closely related to auton

Autonomic Nervous System Dysregulation vs. Functional Gastrointestinal Disorders (3)

Dr.
Chen: I apologize for the previous questions I asked you; I have some additional information: (1) On August 1st, I underwent another gastroscopy, and the results indicated a duodenal ulcer, which has healed, with no gastric ulcer present.
(2) Recently, after dinner, I have been taking medication (Foan 10mg, Homagyl 50mg, and Diazepam 2mg), but if I miss my sleep time (meaning I feel drowsy or get woken up), I experience insomnia that night and wake up early (around 5 AM).
Is this a sign of potential medication dependence? (3) I take Foan 10mg, Homagyl 50mg, and Diazepam 2mg only once a day; I am unsure whether it is better to take them in the morning, afternoon, or evening.
Best regards.

Johnson Chin, 30~39 year old female. Ask Date: 2003/08/20

Dr. Chen Wenke reply Psychiatry

Hello Johnson:
In response to your previous two emails regarding your current condition and to address your questions, there are no significant signs of gastric ulcers.
It can be confirmed that many of your gastrointestinal discomfort symptoms are closely related to autonomic nervous system dysregulation and stress.
Therefore, the medication you are taking, diazepam 2mg, is not a high dose; its primary function is to relax the smooth muscles of the stomach, alleviating discomfort caused by anxiety and stress.
Some physicians may prescribe a dosage of three times a day, which has shown good results.
The current dosage you are using is not considered high, and if this dosage helps you maintain stability, there is no need to worry about further reduction.
As for the timing of your medication, you can adjust it according to your daily schedule; taking it before bedtime should be fine.
Regarding kascoal, primperan, garter, and strocain, these are all medications related to gastrointestinal issues, primarily aimed at addressing bloating and poor digestion.
Foam 10mg contains oxazepam, which is an anti-anxiety medication with a mechanism and purpose similar to that of diazepam.

Additionally, concerning the medications, both diazepam and foam are classified as Schedule IV controlled substances, which have addictive properties.
Therefore, caution is advised when using them.
Based on your description, it does not appear that you are in a state of addiction, so there is no need for excessive concern.

Reply Date: 2003/08/20

More Info

Understanding autonomic nervous system (ANS) disorders and functional gastrointestinal (GI) issues is crucial for managing symptoms effectively. The interplay between these two systems can significantly impact an individual's quality of life, particularly when it comes to gastrointestinal health.

1. Autonomic Nervous System and Functional Gastrointestinal Disorders: The autonomic nervous system regulates involuntary bodily functions, including digestion. It has two main branches: the sympathetic nervous system (which prepares the body for stress or emergencies) and the parasympathetic nervous system (which promotes relaxation and digestion). Dysregulation of the ANS can lead to functional gastrointestinal disorders, such as irritable bowel syndrome (IBS) or functional dyspepsia. Symptoms may include abdominal pain, bloating, and altered bowel habits. In your case, the diagnosis of functional gastrointestinal issues likely stems from the underlying autonomic dysfunction, which can exacerbate symptoms like abdominal bloating and reduced appetite.

2. Medication and Its Effects: You mentioned taking Foan (oxazepam), Homagyl (which contains homatropine), and Diazepam. Each of these medications has specific roles:
- Foan (Oxazepam): This is an anxiolytic that can help reduce anxiety and promote relaxation, which may indirectly alleviate gastrointestinal symptoms by reducing stress.

- Homagyl: This medication can affect gastrointestinal motility, potentially slowing down the movement of the gut, which might contribute to feelings of fullness or bloating.

- Diazepam: Similar to oxazepam, it is used for anxiety and muscle relaxation. However, it can also lead to sedation, which might affect your sleep patterns.

Regarding your concern about potential addiction, while Diazepam and Oxazepam are controlled substances with a risk of dependence, using them as prescribed and monitoring your dosage can mitigate this risk. If you find yourself needing to increase the dosage or feeling anxious about missing doses, it may be worth discussing with your healthcare provider.

3. Timing of Medication: The timing of your medications can influence their effectiveness. Generally, taking these medications in the evening may help with sleep and reduce nighttime anxiety, which could improve your overall sleep quality. However, it’s essential to tailor this to your daily routine and any specific advice from your healthcare provider.

4. Loss of Appetite: The absence of hunger can indeed be linked to functional gastrointestinal disorders. Stress and anxiety can significantly impact appetite regulation. Additionally, medications like Homagyl may contribute to a sensation of fullness, further diminishing your desire to eat. It’s crucial to monitor this symptom, as prolonged loss of appetite can lead to weight loss and nutritional deficiencies.

5. Physical Therapies and Lifestyle Changes: Beyond medication, lifestyle modifications can play a significant role in managing autonomic dysfunction and functional GI disorders. Regular exercise, such as walking or yoga, can help regulate the autonomic nervous system and improve gastrointestinal motility. Stress management techniques, including mindfulness, meditation, and adequate sleep, are also beneficial. Massage therapy, particularly focusing on the abdomen and reflexology, may help alleviate tension and promote relaxation.

6. Consultation and Follow-Up: Given your ongoing symptoms and concerns, it may be beneficial to have a follow-up consultation with your healthcare provider. They can assess your current treatment plan, consider adjustments, and explore additional therapeutic options, including cognitive-behavioral therapy (CBT) for anxiety management or dietary modifications to address gastrointestinal symptoms.

In summary, understanding the relationship between autonomic nervous system disorders and functional gastrointestinal issues is essential for effective management. A comprehensive approach that includes medication, lifestyle changes, and regular follow-up with healthcare professionals can significantly improve your quality of life. If symptoms persist or worsen, further evaluation may be warranted to rule out other underlying conditions.

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