Gastric emptying in postural tachycardia syndrome: a preliminary report

Park, Ki-Jong; Singer, Wolfgang; Sletten, David M.; Low, Phillip A.; Bharucha, Adil E.

doi:10.1007/s10286-013-0193-y

Cited by 38 publications

(39 citation statements)

References 32 publications

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“…Of note, abnormalities in GI motility provoke symptoms such as early satiety, nausea, bloating, and abdominal pain [30]. Four of these studies that describe the GI symptoms in POTS also reported evidence of abnormal gastric motility- either rapid gastric emptying (43%) or delayed gastric emptying (gastroparesis, 20%) [5, 36, 48, 67]. …”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

2018

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Gastrointestinal symptoms are among the most common complaints in patients with postural tachycardia syndrome (POTS). In some cases, they dominate the clinical presentation and cause substantial disabilities, including significant weight loss and malnutrition, that require the use of invasive treatment to support caloric intake. Multiple cross-sectional studies have reported a high prevalence of gastrointestinal symptoms in POTS patients with connective tissue diseases, such as Ehlers-Danlos, hypermobile type, and in patients with evidence of autonomic neuropathy. Previous studies that evaluated gastric motility in these patients reported a wide range of abnormalities, particularly delayed gastric emptying. The pathophysiology of gastrointestinal symptoms in POTS is likely multifactorial and probably depends on the co-morbid conditions. In patients with POTS and Ehlers-Danlos syndromes, structural and functional abnormalities in the gastrointestinal connective tissue may play a significant role, whereas in neuropathic POTS, the gastrointestinal tract motility and gut hormonal secretion may be directly impaired due to localized autonomic denervation. In patients with normal gastrointestinal motility but persistent gastrointestinal symptoms, gastrointestinal functional disorders should be considered. We performed a systematic review of the literature related to POTS and gastrointestinal symptoms have proposed possible mechanisms and discussed diagnosis and treatment approaches for delayed gastric emptying, the most common gastrointestinal abnormality reported in patients with POTS.

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Section: Resultsmentioning

confidence: 99%

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

2018

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“…12 Multi-Ethnic Study of Atherosclerosis utilized an exponential survival model to estimate the arterial age as a function of CAC. 13 The same research group has published a method of calculating CAC by age- and gender-matched percentile rank.…”

Section: Methodsmentioning

confidence: 99%

HIV and coronary artery calcium score: comparison of the Hawaii Aging with HIV Cardiovascular Study and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts

Chow

Young

Valcour

et al. 2015

HIV Clinical Trials

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Objectives To determine the association of HIV, immunologic, and inflammatory factors on coronary artery calcium (CAC), a marker of subclinical atherosclerosis. Methods Cross-sectional study comparing baseline data of males from Hawaii Aging with HIV –Cardiovascular Study (HAHCS) with the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The cohorts were pooled to determine effects of HIV on CAC and explore immunologic and inflammatory factors that may explain development of CAC in HIV. Multivariable regression models compared CAC prevalence in HAHCS with MESA adjusting for coronary heart disease (CHD) risk profiles. Results We studied 100 men from HAHCS and 2733 men from MESA. Positive CAC was seen in 58% HAHCS participants and 57% MESA participants. Mean CAC was 260.8 in HAHCS and 306.5 in MESA. Using relative risk (RR) regression, HAHCS participants had a greater risk (RR=1.20, P<0.05) of having positive CAC than MESA when adjusting for age, smoking status, diabetes, antihypertensive therapy, BMI, systolic blood pressure, total cholesterol, and HDL cholesterol. Among participants with positive CAC, HIV infection was not associated with larger amounts of CAC. Among HAHCS participants, current HIV viral load, CD4, length of HIV, interleukin 6 (IL-6), fibrinogen, C-reactive protein (CRP), and D-dimer were not associated with the presence or amount of CAC. Discussion HIV was independently associated with a positive CAC in men with increased likelihood occurring between 45 and 50 years of age. Current HIV viral load, CD4 count, length of HIV, and inflammatory markers were unrelated to either presence or amount of CAC.

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“…Electrical activity of the stomach has been shown to change during upright position in children with POTS, and both increased and decreased gastric emptying has been noted as well (16,17). Functional gastrointestinal disorders, such as irritable bowel syndrome and functional dyspepsia, are also associated with POTS, suggesting the possibility that increased variability of the gastric pacemaker rhythm and sympathetic nervous system dysfunction in POTS can directly disturb gastrointestinal function (18).…”

Section: Discussionmentioning

confidence: 99%