Gastrointestinal dysfunction in postural tachycardia syndrome

Wang, Liz B.; Culbertson, Collin; Deb, Anindita; Morgenshtern, Karen; Huang, Hao; Hohler, Anna DePold

doi:10.1016/j.jns.2015.10.052

Cited by 39 publications

(29 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

2018

View full text Add to dashboard Cite

show abstract

“…GI symptoms such as nausea, vomiting and bloating, 11,12 and GI dysmotility. [12][13][14] No existing studies involving upper GI physiology in JHS patients have subtyped them according to PoTS status.…”

Section: Independent Of Jhs the Presence Of Pots Is Associated With mentioning

confidence: 99%

“…A large proportion of patients with JHS also suffer with postural tachycardia syndrome (PoTS), a form of orthostatic intolerance typically presenting with palpitations, dizziness, shortness of breath, and syncope which can occur postprandially and with postural changes. Independent of JHS, the presence of PoTS is associated with upper GI symptoms such as nausea, vomiting and bloating, and GI dysmotility . No existing studies involving upper GI physiology in JHS patients have subtyped them according to PoTS status.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms underlying reflux symptoms and dysphagia in patients with joint hypermobility syndrome, with and without postural tachycardia syndrome

Fikree

Aziz

Sifrim

2017

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…Gastrointestinal (GI) symptoms occur commonly in patients with POTS and are a source of considerable frustration, disability, and impairment in quality of life . The cause of these GI symptoms, in many instances, remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…3 Gastrointestinal (GI) symptoms occur commonly in patients with POTS and are a source of considerable frustration, disability, and impairment in quality of life. [6][7][8][9][10] The cause of these GI symptoms, in many instances, remains unclear. Studies evaluating gastric transit in POTS have shown that a significant proportion of patients with POTS have abnormalities in gastric emptying, with rapid emptying occurring more commonly than delayed emptying.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Use of Nonoral Nutrition and Hydration Support in Adult Patients With Postural Tachycardia Syndrome

Tseng

Traub

Harris

et al. 2018

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Background Patients with postural tachycardia syndrome (POTS) often have gastrointestinal (GI) symptoms. Occasionally, these symptoms can be so severe that nonoral nutrition/hydration support (NONHS), including intravenous fluids (IVFs), enteral nutrition (EN), and parenteral nutrition (PN), becomes necessary. Methods This is a retrospective cohort study of adult patients diagnosed with POTS at the Mayo Clinic Arizona from January 2010 to January 2017 with a minimum of 6 months of follow up. Demographic information, symptomatology, medications, GI testing, autonomic and autoantibody testing, and healthcare utilization data were abstracted from the electronic medical record. Results Three‐hundred thirty‐two patients with POTS were included, of which 32 required NONHS. Patients receiving NONHS were more likely to be female; have lower body mass index; have GI symptoms including nausea, vomiting, diarrhea, and constipation; have abdominal pain; use opiates; have delayed gastric emptying; see more specialists; and be seen in an emergency room or be hospitalized for symptoms. Of these patients, 21 (66%) required IVF, 19 (59%) required EN, and 9 (28%) required PN. Six (19%) patients required all 3 NONHS modalities at some point during their follow‐up period. Conclusions NONHS may be required in a subset of patients with POTS. Those receiving NONHS have more severe symptoms and abnormal GI motility and autonomic testing and exhibit greater healthcare utilization. Management of these patients is complex and challenging and requires a multidisciplinary approach. Further prospective studies are needed to identify optimal management strategies.

show abstract

Gastrointestinal dysfunction in postural tachycardia syndrome

Cited by 39 publications

References 13 publications

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

Mechanisms underlying reflux symptoms and dysphagia in patients with joint hypermobility syndrome, with and without postural tachycardia syndrome

Factors Associated With Use of Nonoral Nutrition and Hydration Support in Adult Patients With Postural Tachycardia Syndrome

Contact Info

Product

Resources

About