Peer-reviewed article
Gastrointestinal Comorbidities of Autonomic Dysfunction and Orthostatic Disorders.
Peter T Osgood, Bonnie S Essner, Gisela Chelimsky, John E Fortunato ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a clinical review of autonomic nervous system disorders in children and adolescents, focusing on how orthostatic intolerance co-occurs with gastrointestinal symptoms like pain, nausea, and vomiting. The document discusses how these conditions cause functional impairment and recommends a holistic biopsychosocial approach to management. It addresses clinical assessment and treatment strategies for healthcare providers.
Key points
- Autonomic dysfunction commonly presents with orthostatic intolerance in children and adolescents
- Gastrointestinal symptoms frequently co-occur with orthostatic symptoms in these disorders
- Additional symptoms include fatigue, joint pains, and sleep disturbance leading to functional impairment
- Management should use a holistic biopsychosocial model addressing multiple symptoms concurrently
- Treatment must support nutritional needs and normal pediatric growth and development
Limitations
This is a clinical review focused on symptom presentation and management approaches rather than evidence of intervention effectiveness or outcomes. It does not evaluate specific treatments or provide data on prevalence, incidence, or prognosis of these conditions in children.
Abstract
Disorders of the autonomic nervous system commonly present with symptoms of orthostatic intolerance in children and adolescents. These conditions frequently manifest with a combination of orthostatic dizziness and gastrointestinal (GI) symptoms, including pain, nausea, vomiting or regurgitation, changes in bowel habits, or altered nutritional intake, in addition to extraintestinal symptoms (eg, fatigue, joint pains, sleep disturbance) leading to functional impairment. It is necessary for frontline medical professionals to understand the interplay among symptoms within these disorders to more accurately characterize an individual patient's disorder toward appropriate testing and management. Treatment for orthostatic and GI disorders should emphasize a holistic biopsychosocial model of care aimed at addressing patient symptoms, identifying and managing concurrent conditions, supporting nutritional needs along with normal pediatric growth and development, and supporting return to normal physical, mental, and social functioning.