Effect of Fludrocortisone Acetate on Chronic Unexplained Nausea and Abdominal Pain in Children With Orthostatic Intolerance
Abstract
BACKGROUND: We hypothesized that orthostatic intolerance (OI) is associated with gastric dysrhythmias, nausea, and abdominal pain, which improves using fludrocortisone to treat OI. METHODS: Patients (n=16, girls) with OI completed questionnaires before and after fludrocortisone treatment (age 14.8 ± 2.8 years). Ten patients underwent electrogastrograms (EGGs) before fludrocortisone. RESULTS: All EGGs showed gastric dysrhythmias. Fludrocortisone reduced mean scores as follows: nausea, 3.1 ± 0.8 to 2.1 ± 1.1 (P=0.016); dizziness, 3.0 ± 1.0 to 2.2 ± 1.1 (P=0.0371); abdominal pain, 2.8 ± 1.3 to 1.9 ± 1.4 (P=0.0063); flushing, 2.3 ± 1.2 to 1.5 ± 1.4 (P=0.0476); and missing school, 2.2 ± 1.5 to 1.2 ± 1.5 (P=0.0078). CONCLUSIONS: Chronic nausea and abdominal pain accompany OI and improve with OI treatment.
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Fludrocortisone is frequently used for volume expansion in POTS, though evidence supporting its use is quite limited.
“Fludrocortisone is frequently used in the treatment of POTS patients for the purposes of volume expansion, though evidence supporting its use is quite limited (Fortunato et al., 2014).”
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 Fortunato et al., 2014
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- Authors
- Fortunato, J. E., Wagoner, A. L., Harbinson, R. L., D'Agostino, R. B., Shaltout, H. A., & Diz, D. I.
- Affiliations
- University of Colorado Anschutz (US)
- Wake Forest University (US)
- Department of Pediatrics Division of Pediatric Gastroenterology and Nutrition Winston‐Salem NC
- Wake Forest University Health Sciences (US)
- Hypertension and Vascular Research Center Winston‐Salem NC
- Corresponding author
- Fortunato, John E.
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2014-07
- Volume
- 59
- Issue
- 1
- Pages
- 39-43
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2155769487
- Cited by
- 40
- References
- 27
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2022: 5 · 2021: 3 · 2020: 6 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 1 · 2012: 1
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- orthostatic intolerance, fludrocortisone acetate, chronic nausea, abdominal pain, gastric dysrhythmias, electrogastrography, children, dizziness, school absenteeism
- MeSH terms
- Adolescent, Child, Chronic Disease, Female, Fludrocortisone, Humans, Mineralocorticoids, Nausea, Surveys and Questionnaires, Severity of Illness Index, Stomach Diseases, Abdominal Pain, Tilt-Table Test, Postural Orthostatic Tachycardia Syndrome
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