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Postural Tachycardia Syndrome (POTS) and the GI Tract: A Primer for the Gastroenterologist

The American Journal of Gastroenterology (2018) | Download Citation

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Abstract

Postural tachycardia syndrome (POTS) is one of the most common causes of orthostatic intolerance and is being increasingly recognized in clinical practice. Gastrointestinal (GI) symptoms are reported commonly in patients with POTS and pose a considerable management challenge, making it imperative that gastroenterologists be aware of this condition and its GI comorbidities. Although the evidence presented herein does not prove causation, it does support an association between GI symptoms, GI dysmotility, and POTS. At present, the evaluation and treatment of GI symptoms in patients with POTS remains largely empirical. General measures to treat POTS may lead to improvement in both GI and non-GI symptoms. GI symptoms refractory to these measures should prompt further diagnostic evaluation of gastrointestinal dysmotility and appropriate dietary and pharmacologic management. This review focuses its attention on the involvement of the GI tract in POTS including a discussion of GI symptoms and conditions associated with POTS, followed by an analysis of abnormalities in gut physiology described in POTS, and concluding with an overview of management and suggestions for research directions.

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Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, 85259, USA

    • John K. DiBaise MD, FACG
    •  & Lucinda A. Harris MS, MD
  2. Department of Neurology, Mayo Clinic, Scottsdale, AZ, 85259, USA

    • Brent Goodman MD

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Guarantor of the article

John K DiBaise, MD, FACG

Specific author contributions

JKD performed the literature search and composed the manuscript. LAH and BG provided significant intellectual input, reference selection, and critical review of the manuscript. The final draft of this manuscript was reviewed and approved by JKD, LAH, and BG.

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Corresponding author

Correspondence to John K. DiBaise MD, FACG.

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DOI

https://doi.org/10.1038/s41395-018-0215-4