title: Gastric emptying in postural tachycardia syndrome: a preliminary report.
abstract: OBJECTIVE
  Autonomic neuropathy is widely recognized to be associated with upper gastrointestinal symptoms and abnormal (i.e., rapid or slow) gastric emptying. While patients with postural orthostatic tachycardia syndrome (POTS) may also have gastrointestinal symptoms, our understanding of gastric-emptying disturbances in POTS is very limited. The objectives of this study were to evaluate the relationship between gastric-emptying disturbances and gastrointestinal symptoms in patients with POTS.
  
  
  METHODS
  We retrospectively reviewed the medical records of 22 well-characterized patients with POTS and upper gastrointestinal symptoms in whom autonomic (i.e., postganglionic sudomotor, cardiovagal, and adrenergic) functions and gastric emptying were evaluated using standardized techniques and scintigraphy, respectively. Medical records were reviewed retrospectively to assess clinical features, gastric emptying, and autonomic functions.
  
  
  RESULTS
  Over 70 % of patients had nausea and/or vomiting, which was the most common GI symptom; other common symptoms were abdominal pain (59 %), bloating (55 %), and postprandial fullness/early satiety (46 %). Over one-third of patients had abnormal [i.e., rapid (27 %) or delayed (9 %)] gastric emptying. Gastric-emptying disturbances were not significantly associated with GI symptoms, autonomic symptoms or autonomic dysfunction.
  
  
  CONCLUSIONS
  Over one-third of patients with POTS and gastrointestinal symptoms have abnormal, more frequently rapid than delayed gastric emptying. These findings need to be confirmed in a larger cohort of patients.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Ki-Jong
authors.initials: KJ
authors.lastname: Park
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Singer
authors.forename: David M
authors.initials: DM
authors.lastname: Sletten
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Low
authors.forename: Adil E
authors.initials: AE
authors.lastname: Bharucha
mesh_terms: D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005767:Gastrointestinal Diseases / Q000209:etiology; D005769:Gastrointestinal Motility / Q000502:physiology; D018589:Gastroparesis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000031:analogs & derivatives / Q000378:metabolism; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D054972:Postural Orthostatic Tachycardia Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013270:Stomach / Q000000981:diagnostic imaging; D011795:Surveys and Questionnaires; D013671:Technetium Tc 99m Sulfur Colloid; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D008734:Methoxyhydroxyphenylglycol; D013671:Technetium Tc 99m Sulfur Colloid; C010117:3,4-dihydroxyphenylglycol; D009638:Norepinephrine