J Pediatr Gastroenterol Nutr
*Division of Cardiology †Division of Gastroenterology, Children's National Medical Center, Washington, DC.
Published: September 2016
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.
Methods: Thirty-five subjects with OI and GI symptoms were studied. All the subjects had a 24-hour antroduodenal manometry (ADM) study, in conjunction with pharmacologic challenge and autonomic and tilt table testing (TTT).
Results: The mean subject age was 16.2 ± 2.8 years (range 10-23.8 years), and male to female ratio was 10:25. TTT was abnormal in all the 35 subjects, whereas Valsalva testing was abnormal (+40 mmHG) in 21 of 34 (62%) subjects, and corrected QT interval was ≥0.44 seconds in 19 of 35 (54%) subjects. During TTT, GI symptoms were reproduced in 31 of 35 (89%) studies. ADM was found to be abnormal at baseline, before the TTT in 5 of 35 (14%) subjects, whereas it became abnormal in 23 of 34 (68%) subjects during TTT. In addition, the expected response to the pharmacologic challenge was limited. Overall, ADM was abnormal in 26 of 35 (74%) patients either at baseline or during TTT in these subjects with OI.
Conclusions: 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.
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http://dx.doi.org/10.1097/MPG.0000000000001150 | DOI Listing |
J Pediatr Gastroenterol Nutr
January 2025
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA.
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Methods: We conducted a retrospective review of children with RS evaluated at our institution.
J Neurogastroenterol Motil
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Divisions of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
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January 2025
Department of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Hypermobility spectrum disorders (HSD) and hypermobility Ehlers-Danlos syndrome (hEDS) are frequently associated with gastrointestinal symptoms, although the underlying mechanisms remain unclear. This study aimed to compare antroduodenal motility in patients with and without HSD/hEDS. We included 239 patients (50 HSD/hEDS and 189 non-HSD/hEDS) with gastrointestinal symptoms undergoing antroduodenal manometry (ADM).
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Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, the Netherlands.
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Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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