Effect of fludrocortisone acetate on chronic unexplained nausea and abdominal pain in children with orthostatic intolerance

John E. Fortunato*, Ashley L. Wagoner, Rachel L. Harbinson, Ralph B. D'Agostino, Hossam A. Shaltout, Debra I. Diz

*Corresponding author for this work

Research output: Contribution to journalArticle

14 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)39-43
Number of pages5
JournalJournal of pediatric gastroenterology and nutrition
Volume59
Issue number1
DOIs
StatePublished - Jul 1 2014

Keywords

  • Chronic unexplained nausea
  • Dysautonomia
  • Electrogastrogram
  • Fludrocortisone
  • Neurally mediated hypotension
  • Postural orthostatic tachycardia syndrome
  • Tilt table testing

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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