Gastrointestinal autonomic disorders

The Autonomic Nervous System (ANS) is the medium between the central nervous system and the enteric nervous system; the latter exhibits a high degree of autonomy from central nervous control; it is the only human system that developed its own independent organization in evolutionary changes. In the last decade, the scientific knowledge of ANS has been given a major boost mainly regarding enteric sense-motor functions. Often neurological diseases result in ANS GI impairment that, in some cases, cannot always be counteracted by vegetative compensatory mechanisms, or modified by therapeutic treatment. Structures, gastrointestinal motility, and functional gastrointestinal disorders are described with particular attention to autonomic gastrointestinal dysfunction recognized in main neurological diseases. Furthermore, laboratory and instrumental tests for the diagnosis of dysmotility of the gastrointestinal system and suggestions for the management of gastro-enteric failure are reported, to support diagnosis and management of gastrointestinal ANS dysfunction.