Disturbances of gastrointestinal transit and autonomic functions in postural orthostatic tachycardia syndrome

• Published in: Neurogastroenterology and motility 2015-01, Vol.27 (1), p.92-98
• Main Authors: Loavenbruck, A., Iturrino, J., Singer, W., Sletten, D. M., Low, P. A., Zinsmeister, A. R., Bharucha, A. E.
• Format: Article
• Language: English
• Subjects: Adult; Autonomic Nervous System - physiopathology; dumping; Female; gastric emptying; Gastrointestinal Transit - physiology; gastroparesis; Gastroparesis - complications; Gastroparesis - physiopathology; Humans; Male; Postural Orthostatic Tachycardia Syndrome - complications; Postural Orthostatic Tachycardia Syndrome - physiopathology; POTS
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.12480

Background Gastrointestinal symptoms are common in the postural orthostatic tachycardia syndrome (POTS). However, few studies have evaluated gastrointestinal transit in POTS. Our primary objectives were to evaluate gastrointestinal emptying and the relationship with autonomic dysfunctions in POTS. Methods We reviewed the complete medical records of all patients aged 18 years and older with POTS diagnosed by a standardized autonomic reflex screen who also had a scintigraphic assessment of gastrointestinal transit at Mayo Clinic Rochester between 1998 and 2012. Associations between specific gastric emptying and autonomic (i.e., cardiovagal, adrenergic, and sudomotor) disturbances were evaluated. Key Results Among 163 patients (140 women, mean [±SEM] age 30 [±1] years), 55 (34%) had normal, 30 (18%) had delayed, and 78 (48%) had rapid gastric emptying. Fifty‐eight patients (36%) had clinical features of physical deconditioning, which was associated (p = 0.02) with rapid gastric emptying. Associations with delayed gastric emptying included vomiting, which was more common (p