Gastrointestinal Comorbidities of Autonomic Dysfunction and Orthostatic Disorders

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.