Effect of Fludrocortisone Acetate on Chronic Unexplained Nausea and Abdominal Pain in Children With Orthostatic Intolerance

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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.

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