The Connection Between POTS and IBS

In addition to having IBS, I also have Ehlers-Danlos syndrome, which is a connective tissue disease. I've already written about the potential connection between IBS and EDS here, but many (or most) people with EDS also have something known as POTS. Lately, I've been wondering what connection (if any), POTS may have with IBS. So I decided to do some research.

What is POTS?

POTS is the acronym for postural orthostatic tachycardia syndrome. It is a condition that affects circulation and is a form of orthostatic intolerance. In other words, going from a sitting or reclined position to a standing position can cause the heart to race and the blood pressure to drop suddenly, making the person feel lightheaded or faint.

How does POTS relate to IBS?

As a result of my cursory investigation, I found that orthostatic intolerance is often associated with gastrointestinal symptoms. In the vast majority of the cases, these GI problems are not necessarily due to POTS itself necessarily, but rather just a comorbid condition. This means in general, treating POTS may not lead to any alleviation of IBS-like symptoms. However, if the IBS symptoms are more highly associated with changes in positions from sitting/reclined to upright/standing, then treating POTS could potentially have some benefits for those specific cases/instances.¹

POTS and even general orthostatic intolerance (OI) can include symptoms such as nausea, vomiting, and "epigastric discomfort." Some studies even showed that during the tilt table test, transitioning to the upright position in patients can affect up to 68 percent of participants in that they experience GI motility changes and issues, as well as reflux.

How is POTS tested?

I don't know for sure if I have POTS. If I do, it may be low-grade. I couldn't tolerate the tilt table test and when I did a simple sit/stand test (when the nurse or doctor has you sit for a while and then stand while taking your pulse), they had to repeat it several times because my responses kept fluctuating wildly. My heart rate would jump but stopped just short of the limit often earmarked as a clear indicator of POTS. My blood pressure is already very low and tends to plummet even more during stress or taking hot showers, etc. I know that at times, this kind of wooziness has seemed to instigate GI stress. But it is something to bear in mind and make note of for now, even if for the time being I don't have a clear answer.

To me, my body is a puzzle. I want to better understand it, to put together the pieces, to see the clear picture. Every step I do toward that is a step toward healing and better management of my symptoms, even if not an outright cure.

Do you have POTS? If so, do you think it impacts your IBS? Why or why not?