Journal of clinical gastroenterology
September 25, 2026 · via Europe PMC
Orthostatic Intolerance in Patients With Disorders of Gut-Brain Interaction: A Systematic Review and Meta-Analysis.
Ayaki K, Shah A, Fairlie T, +7 more, Holtmann G.
AI summary — for doctors, generated from the abstract only
Orthostatic intolerance affected about half of patients with disorders of gut-brain interaction and POTS about one-third, far more than controls.
What was studied
A systematic review and meta-analysis of 13 studies (869 DGBI patients, 1951 controls) on prevalence of orthostatic intolerance (OI) and POTS in DGBI.
Key findings
- Pooled OI prevalence 50.0% (95% CI 35.0-64.9)
- Odds of OI higher than controls (OR 5.17; 95% CI 1.73-15.50)
- OI more prevalent in children (59.7%) than adults (32.5%) and with Rome IV (66.1%) vs Rome III (30.6%)
- POTS prevalence 31.5% (95% CI 17.3-50.2)
Clinical relevance
Suggests clinicians may consider orthostatic symptoms in DGBI patients, but the evidence is low quality and heterogeneous.
Who should care
Limitations
Few, heterogeneous studies with varying diagnostic methods; authors rate evidence as low quality.
Orthostatic intolerance and POTS are common in DGBI, though evidence is limited.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Patients with severe manifestations of disorders of gut-brain interaction (DGBI) have higher rates of concomitant Orthostatic Intolerance (OI) and Postural Orthostatic Tachycardia Syndrome (POTS). These conditions diminish quality of life and increase health care use. We conducted a systematic review to assess OI and POTS prevalence in patients with DGBI.
Methods
Databases were searched through January 2026 for articles reporting the prevalence of OI and POTS among patients with DGBI. Pooled prevalence rates, odds ratios (ORs), and confidence intervals (CIs) were calculated using a random-effects model.
Key results
Thirteen studies included 869 patients with DGBI and 1951 controls. OI prevalence in DGBI patients was DGBI (PP=50.0%, 95% CI: 35.0-64.9). The odds of OI in patients with DGBI were significantly higher compared with controls (OR=5.17, 95% CI: 1.73-15.50, P=0.003). Pediatric patients with DGBI had a higher prevalence of OI (59.7%, 95% CI: 36.4-79.3) than adults (32.5%, 95% CI: 19.3-49.4). The prevalence of OI in patients with DGBI was significantly higher when diagnosed using the Rome IV criteria (66.1%, 95% CI: 43.3-83.3) compared with the Rome III criteria (30.6%, 95% CI: 21.4-41.6). The prevalence of OI in DGBI was higher with questionnaire-based diagnosis (54.5%, 95% CI: 9.7-93.0) compared with physician-based diagnosis (48.8%, 95% CI: 35.2-62.7). Finally, POTS was prevalent in 31.5% (95% CI: 17.3-50.2) of patients with DGBI.
Conclusions
OI is more prevalent in patients with DGBI as compared with controls without DGBI. POTS occurs in over one-third of patients with DGBI. While OI and DGBI are associated, clinical heterogeneity suggests low-quality evidence, warranting cautious interpretation.
DOI
10.1097/mcg.0000000000002443
PMID
42790485
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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