Mij
Senior Member (Voting Rights)
Abstract
Background
Patients with postural orthostatic tachycardia syndrome (POTS) frequently report higher rates of chronic gastrointestinal symptoms, disorders of gut‐brain interaction (DGBI), and extra‐intestinal co‐morbidities. We conducted a systematic review and meta‐analysis to assess the prevalence of gastrointestinal symptoms and comorbid conditions in POTS patients.
Methods
Electronic databases were searched from inception until May 2025 for studies reporting gastrointestinal symptoms in POTS patients. A random‐effects model was used to pool the proportion of POTS patients reporting gastrointestinal symptoms, and sub‐group analyses were conducted.
Results
The final dataset includes 19 studies, with 8268 POTS patients, revealing that 57.9% (95% CI 38.4–75.2) had at least one gastrointestinal symptom. The most common gastrointestinal symptom was nausea (70.1%, 95% CI 51.5–83.7) followed by bloating (64.9%, 95% CI 48.5–78.4), abdominal pain (60.4%, 95% CI 39.2–78.3) and postprandial fullness (60.4%, 95% CI 45.6–73.6). Irritable bowel syndrome was the most prevalent DGBI, affecting 26.8% (95% CI 15.3–42.4) of POTS patients. The most common extraintestinal comorbidity was anxiety, reported in 42.9% (95% CI 22.7–65.8), followed by chronic fatigue (40.9%, 95% CI 21.1–64.2), migraine (35.6%, 95% CI 27.0–45.2), depression (34.4%, 95% CI 19.0–54.0), and fibromyalgia (21.6%, 95% CI 12.8–34.2). Approximately one third reported mast cell activation syndrome (36.3%, 95% CI 17.8–60.0) and joint hypermobility syndrome (31%, 95% CI 24.4–38.5). There was substantial heterogeneity seen in the primary and most subgroup analyses.
Conclusions
Overall, 60% of POTS patients report concurrent gastrointestinal symptoms, with nausea being the most common. IBS affects 25% of patients with POTS. Notably, extra‐intestinal comorbidities—primarily anxiety, chronic fatigue, migraines, depression, and fibromyalgia—are more prevalent than gastrointestinal conditions in this population.
Study
Background
Patients with postural orthostatic tachycardia syndrome (POTS) frequently report higher rates of chronic gastrointestinal symptoms, disorders of gut‐brain interaction (DGBI), and extra‐intestinal co‐morbidities. We conducted a systematic review and meta‐analysis to assess the prevalence of gastrointestinal symptoms and comorbid conditions in POTS patients.
Methods
Electronic databases were searched from inception until May 2025 for studies reporting gastrointestinal symptoms in POTS patients. A random‐effects model was used to pool the proportion of POTS patients reporting gastrointestinal symptoms, and sub‐group analyses were conducted.
Results
The final dataset includes 19 studies, with 8268 POTS patients, revealing that 57.9% (95% CI 38.4–75.2) had at least one gastrointestinal symptom. The most common gastrointestinal symptom was nausea (70.1%, 95% CI 51.5–83.7) followed by bloating (64.9%, 95% CI 48.5–78.4), abdominal pain (60.4%, 95% CI 39.2–78.3) and postprandial fullness (60.4%, 95% CI 45.6–73.6). Irritable bowel syndrome was the most prevalent DGBI, affecting 26.8% (95% CI 15.3–42.4) of POTS patients. The most common extraintestinal comorbidity was anxiety, reported in 42.9% (95% CI 22.7–65.8), followed by chronic fatigue (40.9%, 95% CI 21.1–64.2), migraine (35.6%, 95% CI 27.0–45.2), depression (34.4%, 95% CI 19.0–54.0), and fibromyalgia (21.6%, 95% CI 12.8–34.2). Approximately one third reported mast cell activation syndrome (36.3%, 95% CI 17.8–60.0) and joint hypermobility syndrome (31%, 95% CI 24.4–38.5). There was substantial heterogeneity seen in the primary and most subgroup analyses.
Conclusions
Overall, 60% of POTS patients report concurrent gastrointestinal symptoms, with nausea being the most common. IBS affects 25% of patients with POTS. Notably, extra‐intestinal comorbidities—primarily anxiety, chronic fatigue, migraines, depression, and fibromyalgia—are more prevalent than gastrointestinal conditions in this population.
Study
