Postural Orthostatic Tachycardia Syndrome (POTS) is a complex condition involving the autonomic nervous system, which regulates many involuntary bodily functions like heart rate, blood pressure, and digestion. This disorder can significantly affect a person’s daily life, leading to a wide array of symptoms that extend beyond the cardiovascular system.
POTS and Digestive Distress
Many individuals with POTS frequently experience digestive issues, including nausea and vomiting. These symptoms are commonly reported, affecting around 70% of POTS patients. These gastrointestinal challenges are part of a broader pattern of digestive dysfunction. Other common complaints include abdominal pain, bloating, and early satiety, which is feeling full after consuming only a small amount of food.
How POTS Affects Digestion
The autonomic nervous system, which is dysregulated in POTS, plays a significant role in controlling digestive processes. When this system does not function properly, food movement through the digestive tract can become slow or irregular. One common issue is delayed gastric emptying, also known as gastroparesis, where food takes longer than normal to move from the stomach into the small intestine. This delay can lead to feelings of nausea and sometimes vomiting.
Altered gut motility is another contributing factor, referring to the uncoordinated movement of muscles in the digestive tract. This disruption in the natural rhythm of digestion can cause discomfort and symptoms like nausea.
Blood pooling, particularly in the splanchnic circulation (the blood supply to abdominal organs), can also affect digestive function. Normally, the body adjusts blood flow to the digestive system after a meal, but in POTS, excessive blood can pool in this area, reducing blood return to the heart and brain. This can worsen symptoms, especially after large meals, as the body struggles to manage blood distribution. Certain medications used to manage POTS, including some salt supplements, can also contribute to digestive upset.
Strategies for Relief
Managing nausea and vomiting in POTS often involves non-pharmacological approaches and lifestyle adjustments. Eating smaller, more frequent meals throughout the day can help prevent the stomach from becoming overly full and reduce post-meal discomfort. Incorporating easily digestible foods, and even pureed foods, can alleviate symptoms. It is helpful to observe if certain foods, such as large carbohydrate-heavy meals, highly processed foods, or those with added sugars, worsen symptoms, and adjust intake accordingly.
Maintaining adequate hydration is important, with a recommended fluid intake of 2 to 3 liters per day for adults, often accompanied by increased salt intake, typically 6 to 10 grams daily. This helps increase blood volume, which can reduce overall POTS symptoms that may indirectly contribute to digestive issues. Electrolyte-rich drinks can be beneficial for this purpose.
Drinking fluids before getting out of bed or sitting or reclining after meals can also help manage symptoms related to blood pooling. For immediate nausea relief, natural remedies like ginger (tea, chews) and peppermint (tea, oil) or lemon may offer relief. Consulting with healthcare providers to develop a personalized management plan, which may include anti-sickness medications if needed, is recommended.