# Dysphagia Symptoms in Patients with Postural Orthostatic Tachycardia Syndrome (POTS): A Qualitative Study

## TL;DR

This study explores how swallowing difficulties affect people with POTS, revealing physical, psychological, and social impacts.

## Contribution

The study is the first qualitative investigation of dysphagia in POTS patients, highlighting unmet clinical needs.

## Key findings

- Patients with POTS report significant swallowing impairment, with a mean DHI score of 4.5.
- Four key themes emerged: physical, psychological, daily life impacts, and dissatisfaction with healthcare.
- Comorbid Ehlers–Danlos syndrome was common among participants, suggesting potential overlapping symptomatology.

## Abstract

Background: Difficulty swallowing is a common complaint in patients with postural orthostatic tachycardia syndrome (POTS), but there are no qualitative studies that examine dysphagia in patients with POTS, resulting in a significant gap in clinical understanding and research. Methods: A structured interview of patients with autonomic disorders was conducted utilizing the Dysphagia Handicap Index (DHI). Results: Eleven participants (age range 21–71, mean age 46 years, eight women) were selected using purposive sampling through online support communities and referrals from Dysautonomia Clinic. All had POTS, and eight had comorbid Ehlers–Danlos syndrome. The data gathered from participants were used to construct thematic descriptions of their lived experiences. The mean DHI score in this cohort was 4.5, indicating significant impairment in swallowing. Four themes emerged from the participant narratives: (1) the negative physical impact of dysphagia, (2) the negative psychological impact of dysphagia, (3) the impact on daily life and relationships, and (4) reduced healthcare satisfaction. Conclusions: We found significant impairment due to reported dysphagia symptoms in patients with POTS. Further studies are needed to elucidate the pathophysiology, severity and type of dysphagia in POTS and to develop targeted therapies.