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Cited by 45Cardiovascular Syncope and Autonomic DisordersGastrointestinal motility and disordersHeart Rate Variability and Autonomic Control

Gastrointestinal dysfunction in postural tachycardia syndrome

Wang, Liz B., Culbertson, Collin J., Deb, Anindita, Morgenshtern, Karen, Huang, Hao, Hohler, Anna DePold·2015·Journal of the Neurological Sciences
DOI 10.1016/j.jns.2015.10.052
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Abstract

Background Postural tachycardia syndrome (POTS) is a dysautonomia defined by an exaggerated increase in heart rate upon changing posture. It is associated with disturbances involving multiple organ systems, including neurologic, dermatologic, and gastrointestinal (GI) symptoms. Previous studies identified GI complaints in these patients and showed gastric emptying and electrical activity abnormalities. However, the full spectrum of GI symptoms and their impact on quality of life remains unclear.Methods A 30-question survey of GI symptoms was collected from 28 patients with POTS seen in the Boston Medical Center Autonomic Clinic. Answers were recorded on a Likert rating scale. Symptoms were positive if patients answered "strongly agree" or "agree" and negative if they answered "strongly disagree" or "disagree." Responses were collected and analyzed.Results The most commonly reported GI symptoms were nausea (86%), irregular bowel movements (71%), abdominal pain (70%), and constipation (70%). Additionally, 82% of patients reported having GI symptoms more than once per week, and 71% reported having seen a GI specialist, and symptoms did not improve with changes in position. Twelve patients had undergone a gastric emptying study, and six of these patients reported receiving a diagnosis of gastroparesis or delayed gastric emptying.Conclusions GI disturbances are common, frequent, and prolonged in patients with POTS, likely impacting quality of life. Given the importance of the enteric nervous system to normal GI functioning, the same autonomic impairment leading to POTS may result in abnormal gut motility and ultimately subjective GI discomfort.

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  • Several other studies have implicated dysmotility at different levels of the GI tract (duodenal, gastric) in POTS.

    “Several other studies have implicated dysmotility at different levels of the GI tract (duodenal, gastric) in POTS (87)(88)(89).”

    From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [89]

  • The cause for these symptoms is likely to be multifactorial, but may be related to changes in splanchnic circulation, presence of small fiber neuropathy or altered vascular compliance related to the generalized tissue laxity in hEDS.

    “The cause for these symptoms is likely to be multifactorial, but may be related to changes in splanchnic circulation, presence of small fiber neuropathy or altered vascular compliance related to the generalized tissue laxity in hEDS. 68 , 69”

    From Hypermobile Ehlers–Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know (2022) · cites this paper as [69]

  • Multisystemic involvement is common in PoTS, with gastrointestinal symptoms (including nausea, irregular bowel movements, abdominal pain, bloating and constipation) the most frequent non-cardiovascular symptoms reported.

    “Multisystemic involvement is common, with gastrointestinal symptoms (including nausea, irregular bowel movements, abdominal pain, bloating and constipation) the most frequent non‐cardiovascular symptoms reported. 68 , 69”

    From Hypermobile Ehlers–Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know (2022) · cites this paper as [69]

  • 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 [67]

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Authors
Wang, L. B., Culbertson, C. J., Deb, A., Morgenshtern, K., Huang, H., & Hohler, A. D.
Affiliations
Boston University (US)
Corresponding author
  • Wang, Liz B.
  • Culbertson, Collin J.
  • Deb, Anindita
  • Morgenshtern, Karen
  • Huang, Hao
  • Hohler, Anna DePold
ORCID
Venue
Journal of the Neurological Sciences
Publisher
Elsevier BV
Published
2015-12
Volume
359
Issue
1-2
Pages
193-196
ISSN
0022-510X (ISSN-L)
DOI
10.1016/j.jns.2015.10.052
OpenAlex
W2178381026
Cited by
45
References
17
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 6
FWCI
4.38
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the Neurological Sciences (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
postural orthostatic tachycardia syndrome, gastrointestinal dysfunction, autonomic dysfunction, gastroparesis, delayed gastric emptying, nausea, constipation, abdominal pain, quality of life, enteric nervous system, intestinal motility
MeSH terms
Adolescent, Adult, Female, Gastrointestinal Diseases, Humans, Male, Severity of Illness Index, Postural Orthostatic Tachycardia Syndrome, Young Adult

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