title: Effect of fludrocortisone acetate on chronic unexplained nausea and abdominal pain in children with orthostatic intolerance.
abstract: 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.
authors.affiliation: *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.
authors.forename: John E
authors.initials: JE
authors.lastname: Fortunato
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Wagoner
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Harbinson
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Hossam A
authors.initials: HA
authors.lastname: Shaltout
authors.forename: Debra I
authors.initials: DI
authors.lastname: Diz
mesh_terms: D015746:Abdominal Pain / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D005438:Fludrocortisone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008901:Mineralocorticoids / Q000627:therapeutic use*; D009325:Nausea / Q000150:complications / Q000188:drug therapy*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications* / Q000188:drug therapy*; D012720:Severity of Illness Index; D013272:Stomach Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D018667:Tilt-Table Test
chemical_list: D008901:Mineralocorticoids; D005438:Fludrocortisone; C034635:fludrocortisone acetate