Antroduodenal Manometry Is Abnormal in Children Presenting With Orthostatic Intolerance and Gastrointestinal Symptoms

Abstract

ADM is frequently abnormal in children with OI and GI symptoms. Upper GI motility studies should be a part of the comprehensive evaluation in this population.

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

“…Chronic pain of different origins including abdomen is frequently co‐morbid with the orthostatic intolerance (OI) and the Postural Tachycardia Syndrome (POTS) . Pain‐related effect on the baroreflex symmetry mechanism, which diminishes tachycardiac baroreflex in response to BP decrease (a putative “pain resilience” mechanism) may determine, as a byproduct, the symptoms of OI and POTS in some patients as one of multiple distinct pathophysiological subtypes within them .…”

“…Chronic pain of different origins including abdomen is frequently co-morbid with the orthostatic intolerance (OI) and the Postural Tachycardia Syndrome (POTS). [83][84][85][86] Pain-related effect on the baroreflex symmetry mechanism, which diminishes tachycardiac baroreflex in response to BP decrease (a putative "pain resilience" mechanism) may determine, as a byproduct, the symptoms of OI and POTS in some patients as one of multiple distinct pathophysiological subtypes within them. 87 Its resilience attribute is concordant with findings of increased orthostatic heart rate response as a biomarker of more universal mechanism of protection against negative affect, chronic pain, and hemorrhage severity.…”

Mechanisms underlying reflux symptoms and dysphagia in patients with joint hypermobility syndrome, with and without postural tachycardia syndrome

“…GI symptoms such as nausea, vomiting and bloating, 11,12 and GI dysmotility. [12][13][14] No existing studies involving upper GI physiology in JHS patients have subtyped them according to PoTS status.…”

“…A large proportion of patients with JHS also suffer with postural tachycardia syndrome (PoTS), a form of orthostatic intolerance typically presenting with palpitations, dizziness, shortness of breath, and syncope which can occur postprandially and with postural changes. Independent of JHS, the presence of PoTS is associated with upper GI symptoms such as nausea, vomiting and bloating, and GI dysmotility . No existing studies involving upper GI physiology in JHS patients have subtyped them according to PoTS status.…”

The gastrointestinal symptoms present in patients with postural tachycardia syndrome: A review of the literature and overview of treatment

“…The vast majority of the patients reproduced the GI symptoms during tilt, suggesting that the symptoms were related to the orthostatic challenge. Furthermore, the head up tilt (HUT) induced abnormalities in antroduodenal motility in 68% of the subjects, with neurogenic intestinal dysmotility, antral hypomotility, visceral hyperalgesia, and regurgitation or a combination of these findings (Moak et al, 2016). Sullivan et al (2005) and later Fortunato et al (2011) documented that nausea replicated during HUT often improves with volume expansion with fludrocortisone.…”