Standing Causing Increase In IBS Symptoms with POTS

[Machair]

When my POTS is flaring in the morning, especially if I have to stand for any length of time, anxiety type feelings are massive, adrenaline surges and with them comes the dreaded IBS type symptoms ie the need to have loose bowels/ diarrhoea. This is worse in hot weather.  Now normally constipation is the situation, but when the pots is flaring on standing it swings the other way which is very inconvenient and embarrassing. I have tried all sorts of elimination diets and there is no improvement, and it is definitely related to all the other symptoms that occur at the same time and is triggered by standing. Has anyone else experienced this and do you have any tips to manage it? I have had these symptoms for over 25 years so it isn't a recent thing, but other than taking Immodium if I know it could happen and I have to be somewhere in the morning I have run out of ideas! What GI symptoms do you have and is diarrhoea one of them? Thank you to you all for helping.x

[Ranga]

I can get that discomfort too, in fact I get it when lying down.   😄. So the moment I want to rest or sleep I am back up to the restroom.

In my case, it does seem to be related to pressure changes (both external and internal) and I suspect that is true for most potsies.

I just have to ride it out when it flares . Avoid drastic barometric pressure changes, and maybe humid and hot places too 

 

[Pistol]

@Machair I can only tell you that I experience the same thing at times. I have HPOTS and have a recorded history of having overactive bowels during high-adrenaline times, and also suspected gastroparesis during other times ( as per gastroenterologist ). The only thing I know to do is to adjust my eating habits to whatever "mood" my body is in at any given time. And what helps me the most on any day is avoiding large meals and carbs, but instead eating six to seven snacks a day. This has helped with the GI symptoms as well as the HR and BP problem ( in addition to meds and other treatments of course ) .

[Machair]

Thank you so much for your replies.

I think it is something many of us have and as you say Pistol it is mostly gastroparesis. I think that is easier to deal with than the opposite times of high adrenaline which makes being out of the house tricky. Not knowing when it is going to be one or the other is also very difficult to predict, but one thing I have noticed which might help someone is that when I have the diarrhoea or loose bowel situation my pulse pressure standing in the morning is low and my heart rate is high, in fact sometimes it can't read it standing so I think adrenaline is being pushed out to keep the blood moving up to the brain. Historically I will see 90/75 standing on a bad day or 85/70 with a very high pulse which is well documented in folk with ME/CFS which I also have. On those days I try to increase fluids salt and electrolytes.I agree about the meals and avoiding large dinners and carbs as this makes thing so much worse.

[Pistol]

4 hours ago, Machair said:

when I have the diarrhoea or loose bowel situation my pulse pressure standing in the morning is low and my heart rate is high,

This is actually a "normal" response of the body to counteract the sudden loss of fluids from diarrhea and/or vomiting. When there is not enough fluid in the vessels the heart has to pump faster to distribute the thicker fluid through the body, which then also requires more pressure to push the thicker fluid. 

[Machair]

I think that is so true but in my case the low pulse pressure and raised heart rate goes before the gut issues so I think adrenaline is playing a big part too in causing the loose bowels.

[Sarah Tee]

There's a medicine called Buscopan (hyoscine butylbromide) that calms bowel spasms. I was given it in hospital a couple of times after bowel surgery, when I had gradually started eating again and my bowel protested a lot. It was very effective, although I had it as an injection so it worked quickly.

BUT I am not sure whether it is suitable for patients with dysautonomia, and it is contraindicated for any kind of slowing of the GI tract, so you would need to run it past your specialist and proceed with caution. It might be contraindicated for someone with intermittent gastroparesis or any history of gastroparesis at all.

I can say that my doctor told me never to take it as I now have a type of constipation. She worded it that it temporarily sedates your bowel, stopping spasms, but also putting you at risk of further slowing if your transit isn't normal speed.

[MikeO]

I would rather think one plausible reason is that when the sympathetic nervous is over stimulated that this will affect how your digestive system works. 

[Jason_X]

I tend to have problems in the morning. I have stage 1 gastroparesis (along with inappropriate sinus tachycardia), and I’ve attributed the morning problems to my stomach quickly emptying out over-digested food that’s been sitting there all night. It can be frustrating because my stomach is uncomfortably slow most of the day, but the lower digestive system is much too fast in morning. I try to make sure that I’m up and moving around for about an hour before I leave the house. That gives my digestive system a chance to flush anything out while I’m near a bathroom. It’s less convenient while traveling.