Effect of fludrocortisone acetate on chronic unexplained nausea and abdominal pain in children with orthostatic intolerance.

J Pediatr Gastroenterol Nutr

*Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, University of Colorado, Aurora †Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition ‡Hypertension and Vascular Research Center §Neuroscience Graduate Program, Wake Forest Graduate School of Arts & Sciences ||Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC.

Published: July 2014

Background: We hypothesized that orthostatic intolerance (OI) is associated with gastric dysrhythmias, nausea, and abdominal pain, which improves using fludrocortisone to treat OI.

Methods: Patients (n=16, girls) with OI completed questionnaires before and after fludrocortisone treatment (age 14.8 ± 2.8 years). Ten patients underwent electrogastrograms (EGGs) before fludrocortisone.

Results: All EGGs showed gastric dysrhythmias. Fludrocortisone reduced mean scores as follows: nausea, 3.1 ± 0.8 to 2.1 ± 1.1 (P=0.016); dizziness, 3.0 ± 1.0 to 2.2 ± 1.1 (P=0.0371); abdominal pain, 2.8 ± 1.3 to 1.9 ± 1.4 (P=0.0063); flushing, 2.3 ± 1.2 to 1.5 ± 1.4 (P=0.0476); and missing school, 2.2 ± 1.5 to 1.2 ± 1.5 (P=0.0078).

Conclusions: Chronic nausea and abdominal pain accompany OI and improve with OI treatment.

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http://dx.doi.org/10.1097/MPG.0000000000000305DOI Listing

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