Addressing autonomic problems in Huntington’s disease

“All body systems would be immobilized without the nervous system. It controls and regulates every bodily activity down to the workings of the tiniest cell.” — World Book Encyclopedia of Science

Because Huntington’s disease (HD) damages neurons, or nerve cells, in the brain, it can cause a variety of issues related to the nervous system. One possible problem is autonomic neuropathy, or damage to the nerves that control automatic functions such as digestion, bladder function, and blood pressure.

As a 2021 article published in the Journal of Personalized Medicine notes, “Nerve damage in HD results in autonomic … dysfunction, which can impact the coordination of nerves and muscles controlling bladder, bowel, and sexual function.”

Our dad died from Huntington’s disease in May 2020. My brother, Gavin, was diagnosed just over two years ago, at the age of 42. Both have experienced various types of autonomic dysfunction.

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Digestive problems

While more research is needed, Huntington’s has been associated with gastrointestinal issues like constipation, diarrhea, and nutrient deficiencies. If nerve damage in HD affects autonomic function, it makes sense that this could include digestion.

Our dad had digestive problems early in his disease. He complained of tummy pain with diarrhea, which seemed to worsen if he was anxious or stressed about something like a doctor’s appointment. Toward the end of his disease, constipation became more of a problem, particularly when he wasn’t able to be as physically active.

Gavin has a lot of tummy pain and digestive problems like our dad did. It appears to be similar to irritable bowel syndrome, and his symptoms seem to worsen if he’s stressed or anxious. In addition, we think he might not be storing or cooking his food properly. He could also be eating food that’s past its expiration date and neglecting hygiene in the kitchen.

My brother has bouts of diarrhea and needs to make frequent bathroom visits on some days. These problems have been ongoing for some time, but he has refused any medical help. His new personal assistant, Robin, has managed to convince Gavin to attend an appointment with his local general practitioner (GP). Robin accompanied him, and Gavin’s blood test results showed some slight changes in his liver function. This will now be monitored through further blood tests and appointments with his GP.

Probiotics and peppermint seemed to benefit both my father and brother, relieving digestive discomfort and many of their symptoms.

Current research suggests a high-fiber diet can not only help improve digestive health, but also cognitive function in patients with HD.

Bladder, bowel, and sexual dysfunction

As noted above, frequent bladder, bowel, and sexual problems have been reported by people with HD. Symptoms may include incontinence, urgency, difficulty emptying the bladder, and loss of bowel control, particularly as the muscles controlling these functions become damaged.

Our dad became quite stressed by the need to urinate frequently, which worsened as his disease progressed. He also experienced increased thirst and drank excessive amounts of tea, coffee, and water, which contributed to his frequent bathroom trips. Gavin doesn’t seem to suffer from the same urinary issues as our dad, so far.

It’s also possible that medication side effects may play a role in urinary and digestive disturbances in people with HD. Any symptoms should be checked with a doctor.

Other issues

Some HD patients have reported other autonomic problems as well, such as “elevated resting heart rate, blood pressure, and core body temperature relative to healthy individuals,” as a 2022 article published in the journal Brain Communications notes. Dad had high blood pressure and needed medication to keep it under control. Last week, I wrote about his and my brother’s difficulties with excessive sweating.

Getting help and advice from Dad’s and Gavin’s general practitioner, neurologist, dietitian, and occupational therapist have helped us to manage these symptoms.

Note: Huntington’s Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Huntington’s Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Huntington’s disease.