Gastric emptying in postural tachycardia syndrome: a preliminary report
Open accessAbstract
Purpose Autonomic neuropathy is widely recognized to be associated with upper gastrointestinal symptoms and abnormal (i.e., rapid or slow) gastric emptying. While patients with postural orthostatic tachycardia syndrome (POTS) may also have gastrointestinal symptoms, our understanding of gastric-emptying disturbances in POTS is very limited. The objectives of this study were to evaluate the relationship between gastric-emptying disturbances and gastrointestinal symptoms in patients with POTS.Methods We retrospectively reviewed the medical records of 22 well-characterized patients with POTS and upper gastrointestinal symptoms in whom autonomic (i.e., postganglionic sudomotor, cardiovagal, and adrenergic) functions and gastric emptying were evaluated using standardized techniques and scintigraphy, respectively. Medical records were reviewed retrospectively to assess clinical features, gastric emptying, and autonomic functions.Results Over 70 % of patients had nausea and/or vomiting, which was the most common GI symptom; other common symptoms were abdominal pain (59 %), bloating (55 %), and postprandial fullness/early satiety (46 %). Over one-third of patients had abnormal [i.e., rapid (27 %) or delayed (9 %)] gastric emptying. Gastric-emptying disturbances were not significantly associated with GI symptoms, autonomic symptoms or autonomic dysfunction.Conclusions Over one-third of patients with POTS and gastrointestinal symptoms have abnormal, more frequently rapid than delayed gastric emptying. These findings need to be confirmed in a larger cohort of patients.
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Approximately one-third of patients with POTS report nausea, vomiting, bloating, or constipation.
“Approximately one-third of patients report nausea, vomiting, bloating, or constipation (Low et al., 1994; Park et al., 2013).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Park et al., 2013
The Introduction reports that nearly 40% of adults with POTS have bloating, 25% have nausea, and smaller proportions have vomiting or constipation. It supports the claim that these symptoms occur in POTS, but does not establish that approximately one-third of patients report at least one of the listed symptoms. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThree studies reported that most POTS patients with GI symptoms have evidence of autonomic neuropathy.
“Three different studies reported that the majority of POTS patients with GI symptoms have evidence of autonomic neuropathy.”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [48]
Four studies of GI symptoms in POTS reported abnormal gastric motility, with rapid gastric emptying in 43% and delayed gastric emptying/gastroparesis in 20%.
“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].”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [48]
Nearly 30% of POTS patients with GI symptoms have an abnormal QSART, a surrogate measure of post-ganglionic autonomic innervation.
“Loavenbruck et al. [39] and Park et al. [48] showed that nearly 30% of POTS patients with GI symptoms have an abnormal quantitative sudomotor axon reflex test (QSART), which is a surrogate measure of post-ganglionic autonomic innervation.”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [48]
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References 31 · Cited by 48
- Authors
- Park, K.-J., Singer, W., Sletten, D. M., Low, P. A., & Bharucha, A. E.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Bharucha, Adil E.
- Venue
- Clinical Autonomic Research
- Published
- 2013-05-25
- Volume
- 23
- Issue
- 4
- Pages
- 163-167
- ISSN
- 0959-9851 (ISSN-L)
- 1619-1560
- PMC
- PMC3737368
- OpenAlex
- W2094732363
- Cited by
- 48
- References
- 31
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 8 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 1 · 2012: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Autonomic Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P01DK068055)
- National Institute of Neurological Disorders and Stroke (P01NS044233, NS-44233, K23NS075141)
- National Center for Research Resources (UL1RR024150)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- postural orthostatic tachycardia syndrome, gastric emptying, autonomic neuropathy, gastrointestinal symptoms, nausea and vomiting, abdominal pain, bloating, postprandial fullness, early satiety, rapid gastric emptying, delayed gastric emptying, autonomic dysfunction, scintigraphy
- MeSH terms
- Adolescent, Adult, Autonomic Nervous System, Female, Gastric Emptying, Gastrointestinal Diseases, Gastrointestinal Motility, Humans, Male, Methoxyhydroxyphenylglycol, Middle Aged, Norepinephrine, Surveys and Questionnaires, Radionuclide Imaging, Retrospective Studies, Stomach, Technetium Tc 99m Sulfur Colloid, Gastroparesis, Radiopharmaceuticals, Postural Orthostatic Tachycardia Syndrome, Young Adult
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