Neuro Praxis Düsseldorf

Indigestion

The vegetative nervous system of the gastrointestinal tract (the so-called "abdominal brain") regulates the transport of food and the digestive functions. In connection with the other symptoms, but also as the only complaint, chronic constipation or irritable bowel syndrome can indicate a disturbance of the nerve functions of the intestine. The diagnosis of a neurogenic disorder of food transport or digestion requires neurological and gastroenterological examinations. The search for a treatable cause of irritable bowel syndrome, diarrhea or constipation is sometimes only successful in cooperation 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 aids. Secondly, medication can be used to improve digestion and relieve discomfort. These are carefully selected with knowledge of the examination results.

Nerves control gastric and intestinal functions

The gastric and intestinal activity is based on reflexes which are mediated by the enteric nervous system, i.e. the nervous system of the intestine and controlled by the vagus nerves and impulses from the sympathetic nerve. The upper gastrointestinal tract (GI tract) from the esophagus to the small intestine is controlled by the brain stem, the vagus nucleus located there and its nerve tract. In the lower part, namely in the small intestine and large intestine, peristalsis, i.e. the transport of food, is kept going by local enteric reflexes. Sympathetic nerve impulses, which are transmitted to the intestine from the switching points next to the spinal cord, can slow down bowel movements.

Disruption of the passage through the esophagus (esophagus) is typically associated with a feeling of pressure behind the breastbone. It can be accompanied by a feeling of difficulty swallowing. Delayed emptying of the stomach can lead to a premature feeling of fullness, a feeling of fullness and abdominal pain. As a result of the disrupted transport of food 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 can be associated with constipation (constipation) on the one hand, but also with accelerated intestinal passage, frequent bowel evacuation and also diarrhea on the other. If constipation and diarrhea recur without a recognizable trigger and cannot be explained with the help of a colonoscopy and imaging tests of the intestine, a neurological cause must also be considered. Constipation and diarrhea, for example, can occur alternately in the context of irritable bowel syndrome.

Neurologische Ursachen gestörter Verdauung

Neurologische Ursachen der Magen- und Darmfunktion im Rahmen von Nervenerkrankungen (Polyneuropathien) sind nicht selten. Oft betreffen diese nicht nur Magen oder Darm. Die Wahrnehmung sensibler Reize in den Beinen oder Armen kann herabgesetzt sein. Es können Missempfindungen der Füße oder Hände bestehen. Die Muskelkraft kann generell vermindert sein. Sorgfältige Untersuchungen der Nervenbahnen zeigen beispielsweise Störungen der Nervenleitung in Beinen und/oder Armen an. Zusätzliche Störungen der Blasenfunktion, der Kreislaufregulation, des Schlafes oder des Schwitzens sind nicht selten.

Auch Erkrankungen des zentralen Nervensystems können mit Störungen von Magen- und Darmfunktionen einhergehen. Besondere Aufmerksamkeit gilt in diesem Zusammenhang neurodegenerativen Erkrankungen wie der Parkinson-Erkrankung. Bereits zu einem frühen Zeitpunkt nicht selten Jahre vor Beginn der Parkinson-Bewegungsstörung können Betroffene unter häufiger Verstopfung und Darmträgheit leiden. Einige Formen der Demenzerkrankungen können mit einer Störung der Darmtätigkeit einhergehen. Infolge einer Erkrankung des zentralen Nervensystems bestehen Störungen des Magens und Darmes oft chronisch fort. Sie können die körperliche Fitness nicht nur durch einen Gewichtsverlust beeinträchtigen. Auch die Aufnahme und zeitgerechte Wirkung von Medikamenten kann durch eine verminderte Tätigkeit von Magen oder Darm (bspw. Gastroparese oder eine Pseudoobstruktion) gestört werden.

Diagnosis and treatment

Diagnosing delayed gastric emptying, constipation or irritable bowel syndrome can be complex. If inflammation or obstacles to the passage in the stomach or intestine are excluded using standard examinations such as gastroscopy and colonoscopy, the search for the causes of the digestive disorder also turns to the neurological causes of disturbed food transport, among other things. X-ray examinations of gastric and intestinal transit times supported by contrast media, but also by measuring esophageal pressure, enable experienced gastroenterologists to assess the control and regulation of gastric and intestinal transit. The cooperation with neurogastroenterologists makes it possible to include specialized examinations of gastric and intestinal functions in diagnostics and also to reveal rare diseases.

Of course, our treatment recommendations are primarily based on the cause of disturbed gastric and intestinal functions. In addition, proven recommendations for nutrition, nutritional supplements and, above all, optimization of the gastric and intestinal passage are given. After careful selection, drugs are used to improve digestion and relieve discomfort.