Evaluation of functional gastrointestinal disorders in autonomic neuropathy

Evaluation of functional gastrointestinal disorders in autonomic neuropathy : The clinical diagnosis of gastrointestinal autonomic neuropathy requires the exclusion of organic diseases since visceral neuropathy is only associa ted with unspecific symptoms. Until now, no diagnostic clinical tools are a vailable to evaluate visceral neuropathy directly. Because of poor correlat ion between intestinal and extra-intestinal neuropathies, visceral neuropat hy can only be considered by functional disorders of the gut, e.g. motility dysfunctions. Suitable methods to determine gastrointestinal dysfunction a re manometry, pH-metry, radiology, scintigraphy and exhalation tests. In fu ture, new technical approaches may extend the possibilities to detect gastr ointestinal autonomic neuropathy. These are the electrogastrogram (EGG) by which dysrhytmia of electrical signals from pacemaker cells of the stomach might be detectable and additional methods that allow systematic recording of neural projections between the gastrointestinal tract and the central ne rvous system (CNS) in humans. By means of these new techniques afferent pro jections (cortical evoked potentials, magnetic resonance encephalography, p ositron emission tomography, functional magnetic resonance tomography) and efferent projections from the CNS to the gastrointestinal tract (transcrani al magnetic stimulation) can be investigated.