Altered gastroesophageal motility in patients with idiopathic orthostatic hypotension1

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Although a variety of neurologic and systemic disorders are associated with abnormal gastroesophageal motility, little is known of gut involvement in patients with idiopathic orthostatic hypotension. To assess upper gastrointestinal motility, five patients with idiopathic orthostatic hypotension underwent esophageal manometry and esophageal and gastric radionuclide transit studies. Three patients had abnormal esophageal manometric studies, and two had abnormal gastric transit. The esophageal emptying study was abnormal in one of two patients. These results and the diversity of findings suggest that the upper gastrointestinal tract is involved in idiopathic orthostatic hypotension, although further work is needed to delineate the extent and the site of the abnormality. Esophageal manometry and gastroesophageal transit studies provide a means of diagnosing patients with idiopathic orthostatic hypotension.



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