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.
Abdominal Pain/drug therapy , Fludrocortisone/analogs & derivatives , Mineralocorticoids/therapeutic use , Nausea/drug therapy , Postural Orthostatic Tachycardia Syndrome/complications , Postural Orthostatic Tachycardia Syndrome/drug therapy , Stomach Diseases/etiology , Abdominal Pain/complications , Adolescent , Child , Chronic Disease , Female , Fludrocortisone/therapeutic use , Humans , Nausea/complications , Severity of Illness Index , Stomach Diseases/diagnosis , Stomach Diseases/physiopathology , Surveys and Questionnaires , Tilt-Table Test
