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Pots and GI symptoms

Jeffrey P Moak, Robin R Fabian, Lindsay C Clarke, Sridhar Hanumanthaiah, John Desbiens, Anil Darbari
OBJECTIVES: Gastrointestinal (GI) symptoms of nausea, vomiting, and abdominal pain are common in patients with orthostatic intolerance (OI), including neurally mediated hypotension (NMH) and postural orthostatic tachycardia syndrome (POTS). Autonomic dysregulation is considered the underlying pathophysiology behind the cardiovascular symptoms of POTS. Because the autonomic nervous system also regulates GI motility, we hypothesized that patients with POTS and GI symptoms will have evidence of autonomic dysmotility of the upper GI tract...
September 2016: Journal of Pediatric Gastroenterology and Nutrition
Hao Huang, Anna DePold Hohler
Postural tachycardia syndrome (POTS) is a syndrome of excessive tachycardia with orthostatic challenge, and relief of such symptoms with recumbence. There are several proposed subtypes of the syndrome, each with unique pathophysiology. Numerous symptoms such as excessive tachycardia, lightheadedness, blurry vision, weakness, fatigue, palpitations, chest pain, and tremulousness are associated with orthostatic intolerance. Other co-morbid conditions associated with POTS are not clearly attributable to orthostatic intolerance...
October 2015: American Journal of Clinical Dermatology
Brianna Lide, Sina Haeri
Purpose Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance characterized by an increased heart rate upon transition from supine to standing, and head-up tilt without orthostatic hypotension. Its etiology is multifactorial, and no clear cause has been identified. Common symptoms include light-headedness, blurred vision, weakness, cognitive difficulties, and fatigue and are often accompanied by palpitations, shortness of breath, syncope, or gastrointestinal symptoms. Management includes volume expansion, physical counter maneuvers, and pharmacological agents such as fludrocortisone, midodrine, propranolol, and pyridostigmine...
April 2015: American Journal of Perinatology Reports
Gisela Chelimsky, Katja Kovacic, Melodee Nugent, Adriane Mueller, Pippa Simpson, Thomas C Chelimsky
OBJECTIVE: To determine if several multisystem comorbid conditions occur more frequently in subjects with tilt-table defined postural tachycardia syndrome (POTS) compared with those without. STUDY DESIGN: Retrospective chart review of 67 subjects aged 6-24 years, referred to a tertiary care neurogastroenterology and autonomic disorders clinic for a constellation of functional gastrointestinal, chronic pain, and autonomic complaints. All patients underwent formal autonomic testing, Beighton scores assessment for joint hypermobility (0-9), and fibromyalgia tender points (0-18) (43 subjects)...
July 2015: Journal of Pediatrics
Anindita Deb, Karen Morgenshtern, Collin J Culbertson, Liz B Wang, Anna DePold Hohler
Postural orthostatic tachycardia syndrome (POTS) is a type of dysautonomia seen most commonly in young women and children. It is defined as an increase in heart rate of 30 beats per minute (bpm) or more within 10 minutes of standing in adults, or by 40 bpm or more in children in the absence of orthostatic hypotension. In addition to typical autonomic symptoms, POTS patients report a wide range of subjective complaints in multiple organ systems, though the exact frequencies are unclear. To address the symptom frequency, we had 39 patients with POTS at our institution complete an intake form consisting of a list of 37 symptoms...
April 2015: Proceedings of the Baylor University Medical Center
Diana Felton, Naamah Zitomersky, Shannon Manzi, Jenifer R Lightdale
Cyclic vomiting syndrome (CVS) is a well-established cause of recurrent vomiting in the pediatric population. Severe vomiting with chronic cannabis use, known as cannabinoid hyperemesis syndrome, has recently been more widely recognized as an etiology of persistent episodic vomiting. In turn, patients presenting with frequent episodes of CVS are now increasingly being screened for cannabinoid use. Because patients with persistent vomiting are also frequently prescribed a proton pump inhibitor (PPI) for their gastrointestinal symptoms, it is important to be aware of the potential for a PPI to cause an interaction that can lead to false-positive urine cannabinoid screening...
April 2015: Pediatrics
A Loavenbruck, J Iturrino, W Singer, D M Sletten, P A Low, A R Zinsmeister, A E Bharucha
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...
January 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Katja Kovacic, Thomas C Chelimsky, Manu R Sood, Pippa Simpson, Melodee Nugent, Gisela Chelimsky
OBJECTIVE: To evaluate the prevalence of joint hypermobility (JH) and comorbid conditions in children and young adults referred to a tertiary care neurogastroenterology and autonomic disorders clinic for functional gastrointestinal complaints. STUDY DESIGN: This was a retrospective chart review of 66 new patients aged 5-24 years who fulfilled at least 1 pediatric Rome III criteria for a functional gastrointestinal disorder (FGID) and had a recorded Beighton score (n = 45) or fibromyalgia tender point score (n = 45) based on physician examination...
November 2014: Journal of Pediatrics
Adam D Farmer, Asma Fikree, Qasim Aziz
Quantitative and qualitative abnormalities in visceral function have been demonstrated in postural orthostatic tachycardia syndrome. Joint hypermobility is frequently associated with both postural orthostatic tachycardia syndrome and gastrointestinal symptoms. Future studies in this area should appropriately and systematically control for the presence of joint hypermobility syndrome.
June 2014: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Christopher H Gibbons, Istvan Bonyhay, Adam Benson, Ningshan Wang, Roy Freeman
OBJECTIVE: To define the neuropathology, clinical phenotype, autonomic physiology and differentiating features in individuals with neuropathic and non-neuropathic postural tachycardia syndrome (POTS). METHODS: Twenty-four subjects with POTS and 10 healthy control subjects had skin biopsy analysis of intra-epidermal nerve fiber density (IENFD), quantitative sensory testing (QST) and autonomic testing. Subjects completed quality of life, fatigue and disability questionnaires...
2013: PloS One
Robert J Huang, Carlene L Chun, Karen Friday, George Triadafilopoulos
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a rare disease that is believed to be mediated by dysautonomia. Gastrointestinal complaints in POTS patients are common and disturbing but not well characterized. AIMS: We hypothesized that gastrointestinal dysmotility may be contributory to these symptoms. METHODS: We studied 12 POTS patients who presented with gastrointestinal symptoms to a tertiary referral center. Gastrointestinal symptoms were quantified using a previously validated symptom questionnaire...
November 2013: Digestive Diseases and Sciences
A P S Hungin, C Mulligan, B Pot, P Whorwell, L Agréus, P Fracasso, C Lionis, J Mendive, J-M Philippart de Foy, G Rubin, C Winchester, N de Wit
BACKGROUND: Evidence suggests that the gut microbiota play an important role in gastrointestinal problems. AIM: To give clinicians a practical reference guide on the role of specified probiotics in managing particular lower gastrointestinal symptoms/problems by means of a systematic review-based consensus. METHODS: Systematic literature searching identified randomised, placebo-controlled trials in adults; evidence for each symptom/problem was graded and statements developed (consensus process; 10-member panel)...
October 2013: Alimentary Pharmacology & Therapeutics
C Strube, E Janecek, L Heuer
The zoonotic roundworm Toxocara canis is considered one of the most common gastrointestinal helminths in dogs in Europe. Infection occurs via embryonated eggs from the environment or the ingestion of paratenic hosts. Pups become infected via intrauterine or lactogenic transmission of larvae from the bitch. Prenatal infection results in major consequences because the infected neonates shed large amounts of T. canis eggs into the environment due to a lack of immunocompetence and the resulting inability to fight the infection...
2013: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Ki-Jong Park, Wolfgang Singer, David M Sletten, Phillip A Low, Adil E Bharucha
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...
August 2013: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
William H Seligman, David A Low, Masato Asahina, Christopher J Mathias
OBJECTIVE: Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients. METHODS: Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years)...
April 2013: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Eduardo E Benarroch
Postural tachycardia syndrome (POTS) is defined by a heart rate increment of 30 beats/min or more within 10 minutes of standing or head-up tilt in the absence of orthostatic hypotension; the standing heart rate is often 120 beats/min or higher. POTS manifests with symptoms of cerebral hypoperfusion and excessive sympathoexcitation. The pathophysiology of POTS is heterogeneous and includes impaired sympathetically mediated vasoconstriction, excessive sympathetic drive, volume dysregulation, and deconditioning...
December 2012: Mayo Clinic Proceedings
Khalil Kanjwal, Beverly Karabin, Mujeeb Sheikh, Lawrence Elmer, Yousuf Kanjwal, Bilal Saeed, Blair P Grubb
BACKGROUND: The long-term efficacy of pyridostigmine, a reversible acetyl cholinesterase inhibitor, in the treatment of postural orthostatic tachycardia syndrome (POTS) patients remains unclear. We report our retrospective, single-center, long-term experience regarding the efficacy and adverse effect profile of pyridostigmine in the treatment of POTS patients. METHODS: This retrospective study included an extensive review of electronic charts and data collection in regards to patient demographics, orthostatic parameters, side-effect profile, subjective response to therapy, as well as laboratory studies recorded at each follow-up visit to our institution's Syncope and Autonomic Disorders Center...
June 2011: Pacing and Clinical Electrophysiology: PACE
Ajitesh Ojha, Thomas C Chelimsky, Gisela Chelimsky
OBJECTIVE: To investigate the frequency of various nonorthostatic complaints in children with postural orthostatic tachycardia syndrome (POTS). STUDY DESIGN: We used our autonomic laboratory database to identify all pediatric patients with traditionally defined POTS who had completed the Ohio Dysautonomia Survey (ODYSA). The responses of the patients to questions targeting various autonomic complaints, including syncope, gastrointestinal symptoms, sleep disturbances, headaches, urinary symptoms, chronic pain, and Raynaud-like symptoms, were collected and analyzed...
January 2011: Journal of Pediatrics
Benoît Foligné, Joëlle Dewulf, Jérôme Breton, Olivier Claisse, Aline Lonvaud-Funel, Bruno Pot
The widely used probiotic bacteria belong to the genera Lactobacillus and Bifidobacterium and have in most cases been isolated from the human gastrointestinal tract. However, other "less conventional" bacteria, from allochthonous or extremophilic origin, sharing similar structural or functional features, may also confer specific health benefits to a host. Firstly, we explored the in vitro immuno-modulatory or immune-stimulatory activities of 25 wine lactic acid bacteria belonging to Oenococcus oeni and Pediococcus parvulus...
June 15, 2010: International Journal of Food Microbiology
Shaista Safder, Thomas C Chelimsky, Mary Ann O'Riordan, Gisela Chelimsky
BACKGROUND: The pathophysiology of functional abdominal pain (FAP) is unknown. The upright portion of a tilt table test triggers typical symptoms in certain children. AIM: To compare the pathophysiology and treatment response of children with FAP whose gastrointestinal symptoms (GI) were replicated (RGI) by tilt table testing (TTT) to those in whom TTT did not have this effect (NRGI). METHODS: An IRB-approved retrospective review of the autonomic laboratory database identified all children tested for GI complaints...
2009: Gastroenterology Research and Practice
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