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Background: Irritable bowel syndrome (IBS) is one of commonly diagnosed gastrointestinal disorder accounting for 30% of referrals. Impaired autonomic cardiovascular function has been recognized in IBS. Citalopram was found to be effective and superior to placebo in managing IBS. SSRI was also found effective in the management of NCS.
Methods: We reviewed charts of 30 patients known to have IBS and referred to the syncope clinic. The tilt-table test was utilized to diagnose 26/30 patients, and their main IBS symptoms were reproduced (abdominal pain, cramps, bloating or an urge for defecation). 8 patients had no follow-up. The mean age of the remaining 22 patients (16 female and 6 male) was 36.4 ± 12.3 years. All of the patients were started on a low dose of citalopram (5-10 mg). Wellbeing-Score (WS) was used to assess the severity of the disease before and after treatment.
Results: Eighteen patients showed significant improvement in both NCS and IBS, while 4 patients showed no improvement in their NCS or IBS symptoms. None of the patients showed separate improvement in either condition. There was an improvement in the mean WS, from 7.5 down to 4.95 on the follow-up (with a difference of 2.55, P-value < 0.001). All of the patients tolerated citalopram with no side effects.
Conclusions: Concomitant IBS and NCS management is challenging. We found citalopram to be safe and effective, especially when the symptoms were reproduced during the tilt table test. However, double-blind and randomized controlled trial is warranted.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Syncope and Other EP Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1279-083
- 2017 American College of Cardiology Foundation