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Gastrointestinal dysfunction in postural tachycardia syndrome.

Liz B Wang1, Collin J Culbertson1, Anindita Deb1

  • 1Boston University School of Medicine, Department of Neurology, 72 E. Concord Street, Boston, MA 02118, United States.

Journal of the Neurological Sciences
|December 17, 2015
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Summary

Gastrointestinal (GI) disturbances are prevalent in Postural Tachycardia Syndrome (POTS), significantly impacting patients' quality of life. Nausea, bowel irregularities, and abdominal pain are common, often requiring specialist consultation.

Keywords:
ConstipationDysautonomiaDysmotilityGastric emptyingGastrointestinal symptomsGastroparesisPOTSPostural tachycardia

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Area of Science:

  • Gastroenterology
  • Autonomic Nervous System Disorders
  • Internal Medicine

Background:

  • Postural Tachycardia Syndrome (POTS) is a form of dysautonomia characterized by an excessive heart rate increase upon assuming an upright posture.
  • POTS affects multiple organ systems, frequently presenting with neurological, dermatological, and gastrointestinal (GI) symptoms.
  • While previous research noted GI complaints and motility issues in POTS, a comprehensive understanding of the symptom spectrum and its quality-of-life implications is lacking.

Purpose of the Study:

  • To investigate the full spectrum of gastrointestinal (GI) symptoms experienced by patients diagnosed with Postural Tachycardia Syndrome (POTS).
  • To assess the frequency and impact of these GI symptoms on the quality of life for individuals with POTS.

Main Methods:

  • A survey comprising 30 questions on GI symptoms was administered to 28 POTS patients at the Boston Medical Center Autonomic Clinic.
  • Patient responses were recorded using a Likert rating scale, with 'strongly agree' or 'agree' indicating a positive symptom report.
  • Collected data were analyzed to identify prevalent GI symptoms and their characteristics.

Main Results:

  • Nausea (86%), irregular bowel movements (71%), abdominal pain (70%), and constipation (70%) were the most frequently reported GI symptoms.
  • A significant majority (82%) experienced GI symptoms weekly, and 71% had consulted a GI specialist without symptom improvement related to positional changes.
  • Gastric emptying studies revealed gastroparesis or delayed gastric emptying in 50% (6 of 12) of patients who underwent the procedure.

Conclusions:

  • Gastrointestinal disturbances are a common, persistent, and burdensome issue for patients with POTS, significantly affecting their quality of life.
  • The autonomic dysfunction underlying POTS may directly contribute to impaired gut motility and resultant GI discomfort.
  • Further research into the gut-brain axis in POTS is warranted to develop targeted therapeutic strategies.