Can Gastroesophageal Reflux Disease (GERD) cause Postural Orthostatic Tachycardia Syndrome (POTS)?

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Last updated: March 18, 2025View editorial policy

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From the Guidelines

There is no established direct causal relationship between Gastroesophageal Reflux Disease (GERD) and Postural Orthostatic Tachycardia Syndrome (POTS), though they can coexist in some patients. GERD is a digestive disorder where stomach acid frequently flows back into the esophagus, while POTS is a form of dysautonomia characterized by an abnormal increase in heart rate upon standing. However, there are several indirect connections worth noting. Both conditions can share symptoms like chest discomfort and palpitations, potentially leading to misdiagnosis. Additionally, the autonomic nervous system dysfunction present in POTS can affect digestive function, potentially worsening GERD symptoms in those who have both conditions. Some medications used to treat GERD, particularly proton pump inhibitors like omeprazole or pantoprazole, may occasionally cause dizziness or heart palpitations as side effects, which might mimic or exacerbate POTS symptoms.

Key Considerations

  • The most recent and highest quality study, 1, provides an expert review on the diagnosis and management of extraesophageal gastroesophageal reflux disease, but does not establish a direct causal relationship between GERD and POTS.
  • Another study, 1, discusses the personalized approach to the evaluation and management of GERD, highlighting the importance of considering multiple factors and potential comorbidities, but does not specifically address the relationship between GERD and POTS.
  • A study from 2023, 1, provides guidance on the diagnosis and management of extraesophageal manifestations of GERD, but does not mention POTS as a related condition.
  • An older study, 1, discusses the evaluation and management of patients with syncope, including those with orthostatic intolerance and POTS, but does not address the relationship between GERD and POTS.

Clinical Implications

  • If you're experiencing symptoms of both GERD and POTS, it's essential to consult with healthcare providers who can properly diagnose and develop appropriate treatment plans for each condition separately.
  • A multidisciplinary approach, considering the potential interactions between GERD and POTS, as well as other comorbidities, is crucial for optimal management.
  • Healthcare providers should be aware of the potential for misdiagnosis and the importance of objective testing for pathologic GERD in patients with suspected extraesophageal manifestations.

From the Research

Gastroesophageal Reflux Disease (GERD) and Postural Orthostatic Tachycardia Syndrome (POTS)

  • There are no direct research papers provided to assist in answering whether GERD can cause POTS.
  • The studies provided focus on the management, diagnosis, and risk factors of GERD, as well as its treatment options, including lifestyle modifications, pharmacological therapy, and surgical interventions 2, 3, 4, 5, 6.
  • None of the studies mention a direct link between GERD and POTS, suggesting that the relationship between the two conditions is not addressed in the provided evidence.
  • Further research would be necessary to determine if there is a connection between GERD and POTS.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Management of gastroesophageal reflux disease.

Disease-a-month : DM, 2020

Research

American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: methodology and review of evidence.

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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