Postural Tachycardia Syndrome (POTS) and the GI Tract: A Primer for the Gastroenterologist
Abstract
Postural tachycardia syndrome (POTS) is one of the most common causes of orthostatic intolerance and is being increasingly recognized in clinical practice. Gastrointestinal (GI) symptoms are reported commonly in patients with POTS and pose a considerable management challenge, making it imperative that gastroenterologists be aware of this condition and its GI comorbidities. Although the evidence presented herein does not prove causation, it does support an association between GI symptoms, GI dysmotility, and POTS. At present, the evaluation and treatment of GI symptoms in patients with POTS remains largely empirical. General measures to treat POTS may lead to improvement in both GI and non-GI symptoms. GI symptoms refractory to these measures should prompt further diagnostic evaluation of gastrointestinal dysmotility and appropriate dietary and pharmacologic management. This review focuses its attention on the involvement of the GI tract in POTS including a discussion of GI symptoms and conditions associated with POTS, followed by an analysis of abnormalities in gut physiology described in POTS, and concluding with an overview of management and suggestions for research directions.
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POTS may co-occur with hypermobility-type Ehlers-Danlos syndrome, fibromyalgia, chronic fatigue, interstitial cystitis, and functional GI disorders.
“POTS may co-occur with hypermobility-type Ehlers–Danlos syndrome, fibromyalgia, chronic fatigue, interstitial cystitis (DiBaise et al., 2018), and functional GI disorders (Tai et al., 2020).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as DiBaise et al., 2018
Gastrointestinal dysmotility is frequently diagnosed in POTS.
“Clinical diagnostic studies to identify gastrointestinal dysfunction are limited; however, gastrointestinal dysmotility is frequently diagnosed in POTS (DiBaise et al., 2018; Zhang et al., 2019).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as DiBaise et al., 2018
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- Authors
- DiBaise, J. K., Harris, L. A., & Goodman, B.
- Affiliations
- Mayo Clinic (US)
- Venue
- American Journal of Gastroenterology
- Published
- 2018-10
- Volume
- 113
- Issue
- 10
- Pages
- 1458-1467
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2885678623
- Cited by
- 57
- References
- 21
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 7 · 2019: 2 · 2018: 2
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- The American Journal of Gastroenterology (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, orthostatic intolerance, gastrointestinal symptoms, gastrointestinal motility disorders, gut physiology, dietary management, pharmacological management, comorbidities
- MeSH terms
- Ehlers-Danlos Syndrome, Feeding Behavior, Gastroenterology, Gastrointestinal Agents, Gastrointestinal Diseases, Gastrointestinal Motility, Humans, Mastocytosis, Patient Care Team, Patient Education as Topic, Comorbidity, Neurotransmitter Agents, Gastrointestinal Tract, Postural Orthostatic Tachycardia Syndrome, Physical Conditioning, Human
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