Question and Answer Forum

Postural Orthostatic Tachycardia Syndrome: Feeling Worse After a Meal

By David S. Bell, MD, FAAP

Published in Lyndonville News, March 2001

Question:

Dear Dr. Bell,

I'm sure you're very busy, so I'll keep this brief. I'm 34, male, and I've had CFS for 16 years. I had almost given up hope until I found your articles about OI & CFS, and so I had my doctor measure my pulse & BP according to your protocol. Turns out my heart rate goes from 90 to 126 & my diastolic blood pressure goes to 100 when I stand up. This is great news -- at last, concrete evidence of an abnormality!!

May I ask you a couple of quick questions:

Have you encountered patients like myself who seem to feel relatively OK until after they eat a meal? Meals (regardless of what I eat) FORCE me to lie down. Why might this be happening?

What treatment(s) might help me? (I am planning on seeing a neurologist who specializes in POTS, but I wanted to get your thoughts first).

Thank you so much for all of the research that you have done. Your work is a beacon of hope to all CFS sufferers.

Sincerely,

Drew

Answer:

Dear Drew,

Sorry to hear that you have been sick for 16 years. What you describe with eating is a variation that is constant for some people. Most often it is misinterpreted as food allergies. What I think happens is that eating opens the blood vessels of the gut (to process the food) Because of this, there is less blood available to the brain and the symptoms become worse. To a minor extent, this process happens with everybody, and it is the reason that some countries and societies have nap time after lunch. I think we should adopt the Italian schedule of resting for several hours after lunch, and working early evening. I am sorry to say that I don't know of any other way to treat it.

Best Wishes,

Dr. Bell

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