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

Fikree, Asma; Aziz, Qasim; Sifrim, Daniel

doi:10.1111/nmo.13029

Cited by 20 publications

(31 citation statements)

References 42 publications

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“…Furthermore, 60% had functional dysphagia with normal esophageal motility. The POTS group was more likely to have esophageal hypomobility and pathological gastro-esophageal reflux [19]. …”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

2018

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Gastrointestinal symptoms are among the most common complaints in patients with postural tachycardia syndrome (POTS). In some cases, they dominate the clinical presentation and cause substantial disabilities, including significant weight loss and malnutrition, that require the use of invasive treatment to support caloric intake. Multiple cross-sectional studies have reported a high prevalence of gastrointestinal symptoms in POTS patients with connective tissue diseases, such as Ehlers-Danlos, hypermobile type, and in patients with evidence of autonomic neuropathy. Previous studies that evaluated gastric motility in these patients reported a wide range of abnormalities, particularly delayed gastric emptying. The pathophysiology of gastrointestinal symptoms in POTS is likely multifactorial and probably depends on the co-morbid conditions. In patients with POTS and Ehlers-Danlos syndromes, structural and functional abnormalities in the gastrointestinal connective tissue may play a significant role, whereas in neuropathic POTS, the gastrointestinal tract motility and gut hormonal secretion may be directly impaired due to localized autonomic denervation. In patients with normal gastrointestinal motility but persistent gastrointestinal symptoms, gastrointestinal functional disorders should be considered. We performed a systematic review of the literature related to POTS and gastrointestinal symptoms have proposed possible mechanisms and discussed diagnosis and treatment approaches for delayed gastric emptying, the most common gastrointestinal abnormality reported in patients with POTS.

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“…Furthermore, 60% had functional dysphagia with normal esophageal motility. The POTS group was more likely to have esophageal hypomobility and pathological gastro-esophageal reflux [19]. …”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

2018

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“…Patient health questionnaire (PHQ)-9 and General anxiety disorder (GAD)-7 questionnaire-These are nine-and seven-item questionnaires, respectively, which are widely used and validated to assess severity of symptoms of depression and generalized anxiety. 20,21 The PHQ-9 categorizes symptoms of depression as none (score: 0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19), and severe (20-27). 20 The GAD-7 categorizes symptoms of anxiety as mild (score 0-5), moderate (6-10), moderately severe (11)(12)(13)(14)(15), and severe (16)(17)(18)(19)(20)(21).…”

Section: Key Pointsmentioning

confidence: 99%

“…17,18 However, these studies are small and those pertinent to gastroenterology limited to evaluating esophageal symptoms of dysphagia and reflux only. 17 There have been no studies examining how POTS in HSD/hEDS affects the whole repertoire of Rome IV FGIDs, in terms of their individual presence, but also symptom severity. We aimed to study this in depth by using a large sample of individuals with HSD/hEDS.…”

Section: Introductionmentioning

confidence: 99%

Functional gastrointestinal disorders are increased in joint hypermobility‐related disorders with concomitant postural orthostatic tachycardia syndrome

Tai

Palsson

Lam

et al. 2020

Neurogastroenterology Motil

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“…A large proportion of joint hypermobility syndrome patients with esophageal symptoms have exact reflux-related symptoms or esophageal hypomotility, and this is more likely due to POTS [ 21 ]. A study was done in 2016 to suggest a potential association between gluten-related disorders and POTS.…”

Section: Reviewmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome and Its Unusual Presenting Complaints in Women: A Literature Minireview

Anjum

Sohail

Hatipoğlu

et al. 2018

Cureus

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Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that is defined by symptoms of orthostatic intolerance. According to the current criteria for adults, currently, POTS is defined as a heart rate increment of 30 beats/minute or more after 10 minutes of standing in the absence of orthostatic hypotension. There is a vast majority that remains misdiagnosed due to the heterogeneity of the disorder. Due to a lack of Food and Drug Administration (FDA) approved therapy, alternative therapies and over the counter medications are used to alleviate the symptoms. This is an uncommon presentation observed primarily in women, as it is more prevalent in females.

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

Abstract: A large proportion of JHS patients with esophageal symptoms have true reflux-related symptoms or mild esophageal hypomotility, and this is more likely if they have PoTS.

Cited by 20 publications

References 42 publications

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review

Functional gastrointestinal disorders are increased in joint hypermobility‐related disorders with concomitant postural orthostatic tachycardia syndrome

Postural Orthostatic Tachycardia Syndrome and Its Unusual Presenting Complaints in Women: A Literature Minireview

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