Wendy Zhou1, Thomas A Zikos2, John O Clarke2, Linda A Nguyen2, George Triadafilopoulos2, Leila Neshatian3. 1. Department of Medicine, Santa Clara Valley Medical Center, San Jose, USA. 2. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway St, Pav C 3rd Floor, GI Suite, Redwood City, CA, 94063, USA. 3. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway St, Pav C 3rd Floor, GI Suite, Redwood City, CA, 94063, USA. Lneshati@stanford.edu.
Abstract
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disorder that affects multiple organs, including the gastrointestinal system. These patients often have multiple GI complaints with a severe impact on their quality of life. GI dysmotility patterns in POTS remains poorly understood and difficult to manage. AIMS: The aim of this study was to investigate the diagnostic yield of wireless motility capsule in patients with gastrointestinal symptoms and POTS, with use of a symptomatic control group without POTS as a reference. METHODS: We retrospectively reviewed the charts of patients who had both autonomic testing and wireless motility capsule between 2016 and 2020. The two groups were divided into those with POTS and those without POTS (controls) as diagnosed through autonomic testing. We compared the regional transit times and motility patterns between the two groups using the data collected from wireless motility capsule. RESULTS: A total of 25% of POTS patients had delayed small bowel transit compared to 0% of non-POTS patients (p = 0.047). POTS patients exhibited hypo-contractility patterns within the small bowel, including decreased contractions/min (2.95 vs. 4.22, p = 0.011) and decreased motility index (101.36 vs. 182.11, p = 0.021). In multivariable linear regression analysis, migraine predicted faster small bowel transit (p = 0.007) and presence of POTS predicted slower small bowel transit (p = 0.044). CONCLUSIONS: Motility abnormalities among POTS patients seem to affect mostly the small bowel and exhibit a general hypo-contractility pattern. Wireless motility capsule can be a helpful tool in patients with POTS and GI symptoms as it can potentially help guide treatment.
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disorder that affects multiple organs, including the gastrointestinal system. These patients often have multiple GI complaints with a severe impact on their quality of life. GI dysmotility patterns in POTS remains poorly understood and difficult to manage. AIMS: The aim of this study was to investigate the diagnostic yield of wireless motility capsule in patients with gastrointestinal symptoms and POTS, with use of a symptomatic control group without POTS as a reference. METHODS: We retrospectively reviewed the charts of patients who had both autonomic testing and wireless motility capsule between 2016 and 2020. The two groups were divided into those with POTS and those without POTS (controls) as diagnosed through autonomic testing. We compared the regional transit times and motility patterns between the two groups using the data collected from wireless motility capsule. RESULTS: A total of 25% of POTS patients had delayed small bowel transit compared to 0% of non-POTS patients (p = 0.047). POTS patients exhibited hypo-contractility patterns within the small bowel, including decreased contractions/min (2.95 vs. 4.22, p = 0.011) and decreased motility index (101.36 vs. 182.11, p = 0.021). In multivariable linear regression analysis, migraine predicted faster small bowel transit (p = 0.007) and presence of POTS predicted slower small bowel transit (p = 0.044). CONCLUSIONS: Motility abnormalities among POTS patients seem to affect mostly the small bowel and exhibit a general hypo-contractility pattern. Wireless motility capsule can be a helpful tool in patients with POTS and GI symptoms as it can potentially help guide treatment.
Authors: I Sarosiek; K H Selover; L A Katz; J R Semler; G E Wilding; J M Lackner; M D Sitrin; B Kuo; W D Chey; W L Hasler; K L Koch; H P Parkman; J Sarosiek; R W McCallum Journal: Aliment Pharmacol Ther Date: 2009-10-08 Impact factor: 8.171
Authors: Ditte S Kornum; Astrid J Terkelsen; Davide Bertoli; Mette W Klinge; Katrine L Høyer; Huda H A Kufaishi; Per Borghammer; Asbjørn M Drewes; Christina Brock; Klaus Krogh Journal: J Clin Med Date: 2021-03-31 Impact factor: 4.241